Tremors are neurological conditions marked by rhythmic shaking due to involuntary muscle contractions, which can arise from various causes, including drug use, medical conditions like multiple sclerosis or Parkinson’s disease, and substance abuse. Lithium-induced tremors, a type of postural tremor, are common early in treatment and often present as fine hand tremors, particularly in older patients. Differentiating these from extrapyramidal tremors, caused by antipsychotic medications, is crucial for proper management, as each type has distinct underlying mechanisms and treatment approaches.

A case study of a 56-year-old female with schizoaffective disorder-bipolar type, who experienced fine tremors while on aripiprazole and lithium, illustrates the challenges in distinguishing between lithium-induced and antipsychotic-induced tremors. The patient’s tremors were determined to be lithium-induced due to the absence of extrapyramidal symptoms and improvement with propranolol, a standard treatment for lithium-induced tremors. This case emphasizes the importance of thorough clinical evaluation, including considering risk factors and using diagnostic tools like electromyography, to accurately identify the cause of tremors and tailor treatment effectively.

Reference: Singh G, Magny S, Singh H, Singh S, Virk IS. Differentiating Between Lithium Tremors and Extrapyramidal Tremors in a Patient on Long-Term Antipsychotics and Lithium Medication. Cureus. 2023;15(7):e42406. doi: 10.7759/cureus.42406.