Essential tremor is a common neurological disorder that affects the hands, head, and voice. It is three times more common than Parkinson's disease. People with essential tremor experience shaking they cannot control. The tremors can occur in any part of the body. Often the tremors interfere in daily activities such as eating and drinking or getting dressed. The tremors can begin in early adulthood and may become worse with age. In most cases, essential tremor runs in families.
The guideline panel reviewed 211 articles to make evidence-based recommendations on the treatment of essential tremor. Although medications can reduce tremor, they did not eliminate them completely in most cases.
"Though the tremors do not completely disappear with treatment, they can be managed, making a huge difference in the daily lives of people with essential tremor," said guideline author Theresa Zesiewicz, MD, an associate professor of neurology at the University of South Florida in Tampa.
Propranolol, long-acting (LA) propranolol, and primidone were each found to significantly reduce limb tremors and are strongly recommended in the guideline. Propranolol is also used to treat high blood pressure. Primidone is an anti-seizure medication. Propranolol and primidone may be used in combination for limb tremor when either drug is insufficient alone. Propranolol is also recommended for head tremors, although not as strongly as it is recommended for limb tremors.