Which drugs can cause shaking hands?

Any medication may cause certain side effects in some people, and some prescription drugs may cause your hands to tremor (shake). Whether it’s a mild, occasional tremor or constant, significant shaking, shaking hands can affect your quality of life — regardless of the severity. 

Other potential causes include some physical health conditions, like Parkinson’s disease, and some mental health conditions, such as post-traumatic stress disorder (PTSD).

Need a diagnosis or prescription quickly? Optum Perks offers personalized on-demand care in as little as 15 minutes. For $29, answer a few questions online and receive a diagnosis and treatment plan from a US-licensed healthcare professional. Get started here.

Drug types that can make your hands shake or tremor

Many drugs can cause shaking hands, but below are some of the most common examples.

Respiratory inhalers

Some inhalers for asthma and other lung conditions contain compounds called beta-agonists or beta-adrenoceptor agonists. They relax the muscles in the airways, making it easier to breathe. However, these compounds can also cause tremors in some people. 

According to a 2022 review, 7% to 20% of people using these inhalers may experience shaking when they start using them:

• albuterol
• salmeterol (Serevent)
• formoterol (Perforomist)

Antiseizure medications

Antiseizure drugs can help treat conditions like epilepsy, chronic pain, and bipolar disorder by affecting the central nervous system.

A 2022 research review explains that these medications can cause shaking hands by decreasing the activity of electrical signals in the brain. 

Examples of antiseizure medications that can cause tremors include:

• carbamazepine (Carbatrol)
• eslicarbazepine (Apitom)
• lacosamide (Vimpat)
• lamotrigine (Lamictal)
• levetiracetam (Keppra)
• perampanel (Fycompa)
• phenytoin extended (Phenytek)
• pregabalin (Lyrica)
• valproic acid, also called valproate (Depakene)

Antidepressants

Antidepressants are medications to help treat depression and other mental health conditions. They change how your brain uses neurotransmitters to regulate your mood and behavior. 

A 2020 postmarketing study analyzed a safety drug database. It found that 2.8% of reported antidepressant side effects mention movement disorders, including tremors. 

Tremors were most common with:

• tricyclic antidepressants, like clomipramine (Anafranil)
• selective serotonin reuptake inhibitors, such as fluvoxamine (Luvox) and paroxetine (Paxil)
• norepinephrine and dopamine reuptake inhibitors, like bupropion (Wellbutrin)

Antipsychotics

Antipsychotics are medications doctors prescribe to help manage mental health conditions like schizophrenia and bipolar disorder. As with antidepressants, they affect brain neurotransmitters like dopamine to alter how you feel and behave.

A 2021 review noted that antipsychotics can cause movement disorders, including shaking hands. The following drugs may be more likely to cause tremors:

• risperidone (Risperdal)
• olanzapine (Zyprexa)
• haloperidol concentrate

Lithium carbonate (Lithobid) is another type of antipsychotic. Healthcare professionals may prescribe it for bipolar disorder. It affects your neurotransmitters to help treat mania, though researchers have yet to fully understand its exact mechanisms of action.

According to a 2024 article, it can cause new or worsened tremors, which can also affect your hands.

Immunosuppressants

Immunosuppressants calm the immune system. Among their different uses, they help prevent organ rejection after a transplant and manage autoimmune conditions like multiple sclerosis (MS).

Some immunosuppressants can cause hand tremors. A 2018 study considered some examples, which include:

• cyclosporin
• tacrolimus (Prograf)

Thyroid medication

The medication levothyroxine (Levoxyl) is a synthetic thyroid hormone. You take it if you have hypothyroidism, a condition where your body doesn’t produce any or enough thyroid hormones. 

A 2023 research review described that thyroid imbalances or medication changes can cause movement disorders like tremors.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Why can some drugs make your hands shake or tremor?

Researchers have yet to unravel the exact reason why certain drugs cause hand tremors. This side effect may be associated with changes in neurotransmitter activity, like dopamine and norepinephrine.

In the case of antipsychotics, a 2018 comparative study notes that these drugs cause various chemical processes within the brain that could have damaging effects.

Additionally, a 2021 narrative review suggests permanent changes to brain neurons could also be a cause for tremors. 

How long does it last?

For some drugs, shakiness may only be an initial symptom that improves with time as your body gets used to the medication. For example, a 2022 research review notes that this is often the case with asthma inhalers, with most instances of drug-induced tremors resolving once you stop taking the medication.

For other drugs, tremors may develop later in the treatment process. For example, a 2018 review explains that antipsychotic medications may not cause shaking until several months or years after you start taking them.

However, this review and a 2021 narrative review emphasize that with antipsychotic drugs, the tremors could become permanent.

Possible complications

Living with shaky hands can be linked with complications, including:

• Underlying medical conditions: It’s important not to automatically link shaking hands to your medications. Some health conditions, like Parkinson’s disease or MS, can also cause this symptom. 
• Effects on daily activities: Tremors can make it difficult to perform fine motor tasks. Activities that once were routine, like writing, typing, or buttoning a shirt, may become challenging. 
• Emotional distress: Shaking hands may cause social and emotional implications — like feeling self-conscious in public settings, anxiety, or depression. 
• Communication barriers: If the shaking is severe, handshakes, gestures, and other nonverbal cues may be challenging. Tremors can also sometimes extend beyond the hands and affect speech, voice, and mouth movements, making personal interactions difficult.
• Sleep disturbances: In some cases, tremors may continue even during rest. They can make it difficult to fall or stay asleep. 

Consulting a healthcare professional

If you are experiencing hand tremors as a side effect of medication, it is important to speak with a healthcare professional.

They may be able to adjust your medication dose or switch you to a different medication that doesn’t cause hand tremors. They might also explore whether there could be other causes of your shaking hands besides the medications you take.

A doctor or healthcare professional can also recommend medications that treat drug-induced tremors. For example, a 2022 research review lists these options:

• propranolol
• tetrabenazine (Xenazine)
• metoprolol (Lopressor)

Summary

Shaky hands can be a side effect of certain medications, including those to treat asthma, mental health conditions, and epilepsy.

If you’re experiencing hand tremors, it is important to speak with a doctor or healthcare professional. They can help you work out the underlying cause of your hand tremors and develop a treatment plan that works for you.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.