Doxycycline-Induced Hand Tremors: Case Report and Review of Antibiotic-Associated Tremors

Abstract

There are several etiologies for acquired tremors. Medications have been observed to induce tremors. A 64-year-old man initiated oral doxycycline for scalp folliculitis. By the third dose, he noticed development of hand tremors. He continued the medication and the tremor persisted. Doxycycline was stopped after five days. Within three days of discontinuing the drug, all tremors had resolved. Medication-induced tremors have been associated with several drugs. These include antiarrhythmics, antibiotics, antidepressants, antiepileptics, antimycotics, antivirals, bronchodilators, chemotherapeutics, dopamine depleters, drugs of misuse, gastrointestinal drugs, hormones, immunosuppressants, methylxanthines, mood stabilizers, and neuroleptics. Several antibiotics have also been associated with drug-induced tremors. These include aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, folate synthesis inhibitor, glycopeptides, macrolides, penicillins, and tetracyclines. Doxycycline can be added to the list of drugs associated with medication-induced tremors.

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“…Since patients 1 and 4 were receiving steroids and steroids can cause tremor [2], it is critical that steroids be ruled out or confirmed as a cause of resting tremor. Doxycycline is also known to cause tremor [3].…”