[29F] Experiencing muscle rigidity, tremors, and agitation post medication dosage increase

Patient Description

A 29-year-old female reports experiencing muscle rigidity, particularly in the shoulder and neck, severe pulsating headaches on the left side, moderate tremors, and agitation without an apparent trigger. These symptoms have been present for 2-3 days, with the tremors and agitation starting 2 weeks ago, coinciding with an increase in Lithium dosage from 450mg to 600mg ER. The patient takes Lithium, Paxil (40mg), Vyvanse (40mg), and birth control (Apri, unknown mg) between 9-10am daily. The patient has a medical history of bipolar disorder, depression, a liver lesion, and female pelvic problems, with diagnoses made over the past three years. No known drug allergies or recreational drug use is reported. The patient has been on Lithium, Paxil, and birth control for over three years, and Vyvanse for five months.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, it's possible that you're experiencing side effects related to your recent increase in Lithium dosage. Lithium is a medication commonly used to treat bipolar disorder, but it can sometimes cause side effects such as:

  • Neurological effects: Tremors, muscle rigidity, and confusion are known side effects of Lithium. These symptoms can occur at therapeutic doses but are more common when the dose is too high or the drug level in your blood is too high.
  • Cardiovascular effects: Increased heart rate can also be a side effect of Lithium.
  • Gastrointestinal effects: While you didn't mention any specific gastrointestinal symptoms, it's worth noting that Lithium can cause nausea, diarrhea, and other digestive issues.

What you can do

  1. Contact your doctor: It's important to let your doctor know about these symptoms as soon as possible. They may need to adjust your Lithium dosage or try a different medication. Never change your medication dosage without first consulting your doctor.
  2. Monitor your symptoms: Keep track of your symptoms and any changes. This information can help your doctor determine the best course of action.
  3. Stay hydrated and maintain a balanced diet: This can help your body process the medication and may help reduce some side effects.

What you should look out for

Contact your doctor immediately or seek emergency medical attention if:

  • Your symptoms worsen or don't improve
  • You experience severe side effects such as extreme dizziness, slow or irregular heartbeat, fainting, or seizures
  • You have thoughts of suicide or harming yourself

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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10 mo ago

People Also Ask


What are common side effects of increasing Lithium dosage?

Common side effects of increasing Lithium dosage include tremors, muscle rigidity, confusion, increased heart rate, and gastrointestinal issues like nausea and diarrhea. It's important to monitor these symptoms and consult your doctor if they occur.


How can I differentiate between side effects of Lithium and symptoms of my underlying conditions?

Differentiating between side effects and symptoms of underlying conditions can be challenging. It's important to track when symptoms started, any changes in medication, and discuss these with your doctor to determine the cause.


What should I do if I experience severe side effects from my medication?

If you experience severe side effects such as extreme dizziness, irregular heartbeat, fainting, or seizures, contact your doctor immediately or seek emergency medical attention. Do not adjust your medication without consulting your healthcare provider.


How can I manage muscle rigidity and tremors caused by medication?

To manage muscle rigidity and tremors, stay hydrated, maintain a balanced diet, and consult your doctor. They may adjust your medication or suggest other treatments to alleviate these symptoms.


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