jitteriness

Jitteriness is a subjective sense of restlessness and shakiness, often accompanied by a fine tremor in the hands, legs, or voice. It can be perceived by the patient or observed by others and may occur at rest or with activity. Jitteriness is a nonspecific symptom that can reflect a transient physiological state or an underlying medical condition.

Common benign triggers include stress and anxiety, caffeine or nicotine use, and caffeine withdrawal. Medications and substances such as stimulants (amphetamine, methylphenidate), decongestants (pseudoephedrine), beta-agonist inhalers, thyroid hormone, low blood sugar, alcohol or benzodiazepine withdrawal, and illicit drugs can induce jitteriness.

Evaluation involves history, examination, vital signs, and targeted labs: blood glucose, thyroid function tests, electrolyte panel, and a review of medications and substances. Clinicians assess tremor characteristics, onset, duration, and whether jitteriness occurs at rest or with movement. Neurological examination helps distinguish from tremor disorders such as essential tremor or parkinsonism, and from restlessness due to akathisia.

Management targets the underlying cause: reduce or stop contributing substances, adjust medications, treat anxiety or panic symptoms, and address metabolic derangements. In some settings, beta-blockers such as propranolol can reduce tremor and jitteriness; benzodiazepines may be used short term for anxiety-related symptoms. When hypoglycemia or thyroid disease is present, treat promptly.

Most instances are transient and self-limited, but persistent jitteriness warrants medical evaluation to rule out endocrine, neurologic, or drug-related causes.