Essential Tremor
Who to Refer
Who not to Refer
- Treatment naive patients.
Treatment
- Essential tremor is a progressive condition and symptom progression on treatment is expected.
- Initial management: removal of any exacerbating factors (caffeine, alcohol, drugs, thyroid etc)
- 1st line drug treatment (in those with functionally limiting symptoms)
- Propranolol: slow release 80mg daily, increased as required/tolerated to 320mg. If symptoms only in social situations, may consider 10-20mg as required.
- Primidone: 50mg at night. Increased slowly to maximum 250mg bd/tds. Withdraw slowly.
- 2nd line treatment
- Topiramate: 25mg od, increased every 2 weeks as required/tolerated to 150-400mg bd.
Useful Resources