ABSTRACT
I. Beta-Adrenergic Antagonists 146
A. Propranolol 146
B. Metoprolol 148
C. Nadolol 148
D. Atenolol 148
E. Sotalol 148
F. Pindolol 148
G. Arotinolol 149
II. Anticonvulsants 149
A. Primidone 149
B. Topiramate 150
C. Gabapentin 151
D. Phenobarbital 151
III. Benzodiazepines 151
A. Clonazepam 152
B. Alprazolam 152
C. Diazepam 152
IV. Botulinum Toxin 152
V. Alcohol 154
A. Ethanol 154
B. Octanol 154
VI. Carbonic Anhydrase Inhibitors 155
VII. Calcium Channel Antagonists 155
VIII. Atypical Antipsychotics 155
A. Clozapine 155
B. Quetiapine 155
IX. Antidepressants 156
A. Mirtazapine 156
X. Treatment Summary 156
References 156
Essential tremor is one of the most common movement disorders; however, there
are currently no medications that have been developed specifically for the treat-
ment of essential tremor. The medications that are currently used were discovered
by serendipity when tremor reduction was observed after treatment for a conco-
mitant illness. The current treatments are symptomatic and are not known to slow
the progression of the disease. Treatment is generally initiated when the tremor
becomes disabling and interferes with daily activities. The treatment of essential
tremor can be frustrating as there are a limited number of medications available
and these medications are not beneficial for all patients. Consequently, a
large number of patients continue to have significant functional impairment.
This chapter will discuss the medications currently used or under study for
the treatment of essential tremor including beta-blockers, anticonvulsants,
benzodiazepines, botulinum toxin, alcohol, and atypical antipsychotics.
