21 year old with drug induced tremors

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On 2/12/2021
A 21 year old girland she has been feeling lonely and has been experiencing this feeling of being isolated since she was 13 years old.
Around the same age, her grandmother was diagnosed with Alzheimer’s disease and her prognosis kept detoriating over time. Currently she is in a vegetative stage.
The student tells me that her grandmother was very close to her so this caused her feeling even more depressed and lonely.
She even consumed a bottle full of iron tablets, in order to end her life.
She did visit counselling back then but never initiated medication or spoke to her family regarding these issues she's been facing 
1 year back she confronted her mom and she told her how she was feeling and her mother took her to a psychiatrist and that's when she was started on medications

2 months she was diagnosed even with bipolar disorder. She tells that she feels anxious for small things.

She then started to experience since 2 months tremors of Bilateral upper limbs and started finding it hard to write
She was diagnosed with drug induced parkinsons


Reviewed the drugs she has been using 

Review of literature done on 2/12/2021

https://pubmed.ncbi.nlm.nih.gov/15177061/

We report a cohort of 21 patients (12 females and nine males), with a mean age of 42.4 years, who developed tremor after receiving fluoxetine at a mean dose of 25.7 mg per day. The mean latency period for tremor appearance was 54.3 days. Severity was found to be mild. In all patients, tremor was postural, with P<0.0005, compared to patients with rest tremor and P<0.05 compared to action/intention-tremor patients. The frequency range was 6-12 Hz/s. After fluoxetine was discontinued, tremor disappeared in 10 patients after a mean latency period of 35.5 days. In the remaining 11 patients, tremor persisted up to the end of the observation period (a mean of 449 days). We believe that this tremor phenomenon is due to the involvement of the red nucleus and the inferior olivary nucleus through their projections to the thalamus and the spinal cord.

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