I am having head tremors on making eye contact with people despite taking antidepressants. Why?

Hello,

Welcome to icliniq.com.

I would like to know some further details about your symptoms:

1) In which body parts do you get tremors?

2) Are these tremors happen at rest or happen while trying to do some activity by hands, for example, writing, holding a cup, glass, spoon, some object in hands, laying in bed, or sitting comfortably in a chair with hands rested on chair arm or in some particular positions?

3) As you mentioned that it happens when you make eye contact with people and in anxiety situations, does it subside completely if you are relaxed and happy?

4) Since when and in what doses and frequency are you taking Propranolol, Sertraline and Queitiapine daily?

5) Have you undergone any investigations till now? If yes, please send the reports in the attachment.

6) Have you met a psychiatrist? It will be better if you can share the psychiatrist assessment sheet too.

7) Since when you started consuming alcohol? And approximately how much quantity are you taking daily?

8) Do you started to have cravings for alcohol?

9) Is there a history of having similar kinds of tremors to any close blood relative?

10) Do you have intermittent suicidal thoughts also?

11) Do you have any walking difficulty also?

12) Are these tremors increasing or decreasing with time or going on at the same pace in these five years' duration?

Other information:

1) How is your sleep routine? Do you get sleepy soon after lying in bed, or it takes a long time? Once got sleepy, do you have frequent awakenings during sleep? Do you feel fresh on awakening from sleep in the morning?

2) How is your usual mood in day-to-day activities? Happy or toward the sad side (thinking about past events) or toward the worried side (thinking about future things, irritable or something else)?

3) How is your appetite?

I suggest you get the following tests done:

1) T3, T4, and TSH (thyroid-stimulating hormone).

2) Serum Vitamin B12.

3) Serum Vitamin D3.

4) ECG (electrocardiogram).

5) CBC (complete blood count).

6) LFT (liver function test).

7) KFT (kidney function test).

Alcohol is obviously not the treatment option for it. Instead, it can increase the symptoms of tremor and anxiety or associated other psychiatric symptoms. I would suggest you quit alcohol completely.

Please get back with the above reports and details and, if possible, send a video of the tremors.

Hello,

Welcome back to icliniq.com.

You have not attached any video showing the tremors. As per your description, there is the possibility that these tremors can be anxiety-induced. With up and down mood and history of suicidal thoughts, it may be associated with depression too. Still, I would suggest doing the above-mentioned investigations to rule out few things which can mimic such symptoms or can be associated with such symptoms. Your current medications are antidepressant Sertraline, antipsychotic - Quetiapine and Propranolol.

It will be erroneous to prescribe psychiatry medication or modify medication simply by chat information.

But one suggestion can be to try antianxiety Benzodiazepine group medications like Etizolam or Clonazepam and can also try increasing the dose of Propranolol along with your current medications. For these suggestions, you need to discuss them with your treating psychiatrist or neurologist.

Along with medications, I would suggest for:

1) Daily jogging 30 minutes in the morning.

2) Meditation or yoga daily.

3) Psychotherapy sessions can also be helpful.

4) Quit alcohol completely.

I hope this was helpful.