What Causes Persistent Tremors Despite Taking Medication?

Posted on Mon, 19 Dec 2016

Question: How do I titrate a 60 mg capsule of Duloxetine? I take- 60mg Duloxetine, morning, Prescribed by a psychiatrist. 81mg Aspirin, 10mg Glipizide XL 2x daily reduced to 1 Glipizide in the morning by Endocrinologist, 50 mg/1000mg Janumet XR 1 tablet twice daily reduced to 1X in evening by Endocrinologist, Bicalutamide, 50 mg 1X, Urologist, Carb/Levo, tab 25, 100 Mg, 3x daily, self reduced to 2X, because I dry heave and get an upset stomach if I take it at noon, neurologist prescribed for essential tremors, maybe it could be parkinsons but doesn't know if it is any more than Esential tremors
. 40 mg Atorvastatin Calcium nightly, Tamulosin, .4 mg nightly, discontinued by internist.
300 mg Gabapentin, nightly, for pain in my legs and feet, Internist in just the last few weeks.
Do you see the problem I see with the Duloxetine?
I am questioning the use of Carbo/Levo and I still have tremors in my hands and instability in walking.
I want to have relief. I was just hospitalized for 6.1 potassium. they got it down to 5.1 and were happy with that. I went to Urgent care for Broncitis and was told my potassium was too high. It's probably better now too since I pooped out.after being given a purple goo.I was given 3 bags of fluids too. I am taking vitamin D3, 1000 IU, 1x daily prescribed by internist. I am still urinating too much. Overall I stay quiet and watch tv and play bridge online. Please help me out with anything you see in these drugs I really have long periods where I do not do anything.
I drink 2 gals 2percent Milk in 2 days.
Thank you.

Answered by Dr. Sudhir Kumar (9 hours later)

Brief Answer:
Carbo/levo may be stopped.

Detailed Answer:
Thank you for posting your query.

I have noted your clinical details and the list of medications.

Since you do not have features of Parkinson's disease (PD), you may stop Carbidopa/levodop. You have already reduced to 2 times; make it one time, and discontinue after a week.

For essential tremors, preferred medications are propranolol or topiramate. You may start one of them.

For what indication, has the psychiatrist prescribed duloxetine. Duloxetine is usually prescribed for treating neuropathic pain and depression.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
My BLOG: http://bestneurodoctor.blogspot.in

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar