Pharmacological Treatments of Tremor

Chapter
First Online:
Part of the Contemporary Clinical Neuroscience book series (CCNE)

Abstract

This chapter discusses the drugs used in the treatment of tremor and provides a pharmacological therapeutical approach for the management of the main neurological disorders characterized by tremor. Tremor severity and related handicap may vary substantially between patients, and some patients may consider that tremor does not interfere with their quality of life.

Keywords

Levodopa Anticholinergic Dopamine agonist Beta-blocker Primidone Topiramate Benzodiazepines Botulinum toxin 
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References

  1. Abboud H, Ahmed A, Fernandez HH. Essential tremor: Choosing the right management plan for your patient. Cleve Clin J Med. 2011;78(12):821–8.PubMedCrossRefGoogle Scholar
  2. Bhidayasiri R. Differential diagnosis of common tremor syndromes. Postgrad Med J. 2005; 81:756–62.PubMedCrossRefGoogle Scholar
  3. Bier JC, Dethy S, Hildebrand J, Jacquy J, Manto M, Martin JJ, Seeldrayers P. Effects of the oral form of ondansetron on cerebellar dysfunction. A multi-center double-blind study. J Neurol. 2003;250(6):693–7.PubMedCrossRefGoogle Scholar
  4. Bushara KO, Malik T, Exconde RE. The effect of levetiracetam on essential tremor. Neurology. 2005;64:1078–80.PubMedCrossRefGoogle Scholar
  5. Calzetti S, Sasso E, Negrotti A, Baratti M, Fava R. Effect of propranolol in head tremor: Quantitative study following single-dose and sustained drug administration. Clin Neuropharmacol. 1992;15(6):470–6.PubMedCrossRefGoogle Scholar
  6. Ceravolo R, Salvetti S, Piccini P, Lucetti C, Gambaccini G, Bonuccelli U. Acute and chronic effects of clozapine in essential tremor. Mov Disord. 1999;14(3):468–72.PubMedCrossRefGoogle Scholar
  7. Connor GS, Edwards K, Tarsy D. Topiramate in essential tremor: Findings from double-blind, placebo-controlled, crossover trials. Clin Neuropharmacol. 2008;31(2):97–103.PubMedCrossRefGoogle Scholar
  8. Cook D, Dalakas M, Galdi A, Biondi D, Porter H. High-dose intravenous immunoglobulin in the treatment of demyelinating neuropathy associated with monoclonal gammapathy. Neurology. 1990;40:212–4.PubMedCrossRefGoogle Scholar
  9. Deuschl G, Raethjen J, Hellriegel H, Elble R. Treatment of patients with essential tremor. Lancet Neurol. 2011;10(2):148–61.PubMedCrossRefGoogle Scholar
  10. Dyck PJ. Intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy and in neuropathy associated with IgM monoclonal gammapathy of unknown significance. Neurology. 1990;40:327–8.PubMedCrossRefGoogle Scholar
  11. Elble RJ, Lyons KE, Pahwa R. Levetiracetam is not effective for essential tremor. Clin Neuropharmacol. 2007;30(6):350–6.PubMedCrossRefGoogle Scholar
  12. Findley LJ, Cleeves L, Calzetti S. Primidone in essential tremor of the hands and head: A double blind controlled clinical study. J Neurol Neurosurg Psychiatry. 1985;48(9):911–5.PubMedCrossRefGoogle Scholar
  13. Gates PC. Orthostatic tremor (shaky legs syndrome). Clin Exp Neurol. 1993;30:66–71.PubMedGoogle Scholar
  14. Gatto EM, Roca MC, Raina G, Micheli F. Low doses of topiramate are effective in essential tremor: A report of three cases. Clin Neuropharmacol. 2003;26(6):294–6.PubMedCrossRefGoogle Scholar
  15. Gbadamosi J, Buhmann C, Moench A, Heesen C. Failure of ondansetron in treating cerebellar tremor in MS patients–an open-label pilot study. Acta Neurol Scand. 2001;104(5):308–11.PubMedCrossRefGoogle Scholar
  16. Gonzalez-Alegre P, Kelkar P, Rodnitzky RL. Isolated high-frequency jaw tremor relieved by ­botulinum toxin injections. Mov Disord. 2006;21(7):1049–50.PubMedCrossRefGoogle Scholar
  17. Grimaldi G, Manto M. Tremor: From pathogenesis to treatment. London: Morgan & Claypool; 2008.Google Scholar
  18. Grimaldi G, Manto M. Neurological tremor: Sensors, signal processing and emerging applications. Sensors. 2010;10(2):1399–422.PubMedCrossRefGoogle Scholar
  19. Gunal DI, Afşar N, Bekiroglu N, Aktan S. New alternative agents in essential tremor therapy: Double-blind placebo-controlled study of alprazolam and acetazolamide. Neurol Sci. 2000; 21(5):315–7.PubMedCrossRefGoogle Scholar
  20. Habib-ur-Rehman MRCP. Diagnosis and management of tremor. Arch Intern Med. 2000; 160(16):2438–44.PubMedCrossRefGoogle Scholar
  21. Hammond ER, Kerr DA. Ethanol responsive tremor in a patient with multiple sclerosis. Arch Neurol. 2008;65(1):142–3.PubMedCrossRefGoogle Scholar
  22. Handforth A, Martin FC. Pilot efficacy and tolerability: A randomized, placebo-controlled trial of levetiracetam for essential tremor. Mov Disord. 2004;19(10):1215–21.PubMedCrossRefGoogle Scholar
  23. Henderson JM, Portmann L, Van Melle G, Haller E, Ghika JA. Propranolol as an adjunct therapy for hyperthyroid tremor. Eur Neurol. 1997;37(3):182–5.PubMedCrossRefGoogle Scholar
  24. Iwata T, Nakai K, Sakamoto M, Dakeishi M, Satoh H, Murata K. Factors affecting hand tremor and postural sway in children. Environ Health Prev Med. 2006;11(1):17–23.PubMedCrossRefGoogle Scholar
  25. Jiménez-Jiménez FJ, Garcia-Ruiz PJ, Cabrera-Valdivia F. Nicardipine versus propranolol in essential tumor. Acta Neurol (Napoli). 1994;16(4):184–8.Google Scholar
  26. Kipfer S, Stephan MA, Schüpbach WM, Ballinari P, Kaelin-Lang A. Resting tremor in Parkinson disease: A negative predictor of levodopa-induced dyskinesia. Arch Neurol. 2011; 68(8):1037–9.PubMedCrossRefGoogle Scholar
  27. Klebe S, Stolze H, Grensing K, Volkmann J, Wenzelburger R, Deuschl G. Influence of alcohol on gait in patients with essential tremor. Neurology. 2005;65(1):96–101.PubMedCrossRefGoogle Scholar
  28. Koller WC. Pharmacologic treatment of parkinsonian tremor. Arch Neurol. 1986;43(2):126–7.PubMedCrossRefGoogle Scholar
  29. Koller WC, Herbster G. Adjuvant therapy of parkinsonian tremor. Arch Neurol. 1987; 44(9): 921–3.PubMedCrossRefGoogle Scholar
  30. Liou LM, Shih PY. Successful treatment of rubral tremor by high-dose trihexyphenidyl: A case report. Kaohsiung J Med Sci. 2006;22(3):149–53.PubMedCrossRefGoogle Scholar
  31. Manto M, Laute MA. A possible mechanism for the beneficial effect of ethanol in essential tremor. Eur J Neurol. 2008;15(7):697–705.PubMedCrossRefGoogle Scholar
  32. Mehndiratta MM, Satyawani M, Gupta S, Khwaja GA. Clinical and surface EMG characteristics of valproate induced tremors. Electromyogr Clin Neurophysiol. 2005;45(3):177–82.PubMedGoogle Scholar
  33. Melmed C, Moros D, Rutman H. Treatment of essential tremor with the barbiturate T2000 (1,3-dimethoxymethyl-5,5-diphenyl-barbituric acid). Mov Disord. 2007;22(5):723–7.PubMedCrossRefGoogle Scholar
  34. Metzer WS, Paige SR, Newton JE. Inefficacy of propranolol in attenuation of drug-induced ­parkinsonian tremor. Mov Disord. 1993;8(1):43–6.PubMedCrossRefGoogle Scholar
  35. Muenter MD, Daube JR, Caviness JN, Miller PM. Treatment of essential tremor with methazolamide. Mayo Clin Proc. 1991;66(10):991–7.PubMedGoogle Scholar
  36. Ondo WG, Jimenez JE, Vuong KD, Jankovic J. An open-label pilot study of levetiracetam for essential tremor. Clin Neuropharmacol. 2004;27(6):274–7.PubMedCrossRefGoogle Scholar
  37. Ondo WG, Jankovic J, Connor GS, Pahwa R, Elble R, Stacy MA, Koller WC, Schwarzman L, Wu SC, Hulihan JF, Topiramate Essential Tremor Study Investigators. Topiramate in essential tremor: A double-blind, placebo-controlled trial. Neurology. 2006;66(5):672–7.PubMedCrossRefGoogle Scholar
  38. Raj V, Landess JS, Martin PR. Oxcarbazepine use in essential tremor. Ann Pharmacother. 2006; 40(10):1876–9.PubMedCrossRefGoogle Scholar
  39. Rice GP, Lesaux J, Vandervoort P, Macewan L, Ebers GC. Ondansetron, a 5-HT3 antagonist, improves cerebellar tremor. J Neurol Neurosurg Psychiatry. 1997;62(3):282–4.PubMedCrossRefGoogle Scholar
  40. Rodrigues JP, Edwards DJ, Walters SE, Byrnes ML, Thickbroom GW, Stell R, Mastaglia FL. Blinded placebo crossover study of gabapentin in primary orthostatic tremor. Mov Disord. 2006;21(7):900–5.PubMedCrossRefGoogle Scholar
  41. Sadeghi R, Ondo WG. Pharmacological management of essential tremor. Drugs. 2010; 70(17): 2215–28.PubMedCrossRefGoogle Scholar
  42. Sasso E, Perucca E, Fava R, Calzetti S. Primidone in the long-term treatment of essential tremor: A prospective study with computerized quantitative analysis. Clin Neuropharmacol. 1990; 13(1): 67–76.PubMedCrossRefGoogle Scholar
  43. Schapira AH. Monoamine oxidase B inhibitors for the treatment of Parkinson’s disease: A review of symptomatic and potential disease-modifying effects. CNS Drugs. 2011;25(12):1061–71.PubMedCrossRefGoogle Scholar
  44. Serrano-Dueñas M. Use of primidone in low doses (250 mg/day) versus high doses (750 mg/day) in the management of essential tremor. Double-blind comparative study with one-year follow-up. Parkinsonism Relat Disord. 2003;10(1):29–33.PubMedCrossRefGoogle Scholar
  45. Striano P, Coppola A, Vacca G, Zara F, Brescia Morra V, Orefice G, Striano S. Levetiracetam for cerebellar tremor in multiple sclerosis: An open-label pilot tolerability and efficacy study. J Neurol. 2006;253(6):762–6.PubMedCrossRefGoogle Scholar
  46. Vidailhet M, Dupel C, Lehéricy S, Remy P, Dormont D, Serdaru M, Jedynak P, Veber H, Samson Y, Marsault C, Agid Y. Dopaminergic dysfunction in midbrain dystonia: Anatomoclinical study using 3-dimensional magnetic resonance imaging and fluorodopa F 18 positron emission tomography. Arch Neurol. 1999;56(8):982–9.PubMedCrossRefGoogle Scholar
  47. Wills AJ, Brusa L, Wang HC, Brown P, Marsden CD. Levodopa may improve orthostatic tremor: Case report and trial of treatment. J Neurol Neurosurg Psychiatry. 1999;66(5):681–4.PubMedCrossRefGoogle Scholar
  48. Yetimalar Y, Irtman G, Kurt T, Başoğlu M. Olanzapine versus propranolol in essential tremor. Clin Neurol Neurosurg. 2005;108(1):32–5.PubMedCrossRefGoogle Scholar
  49. Zesiewicz TA, Elble RJ, Louis ED, Gronseth GS, Ondo WG, Dewey Jr RB, Okun MS, Sullivan KL, Weiner WJ. Evidence-based guideline update: Treatment of essential tremor: Report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology. 2011; 77(19):1752–5.PubMedCrossRefGoogle Scholar
  50. Zeuner KE, Molloy FM, Shoge RO, Goldstein SR, Wesley R, Hallett M. Effect of ethanol on the central oscillator in essential tremor. Mov Disord. 2003;18(11):1280–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Unité d’Etude du Mouvement (UEM)Neurologie ULB ErasmeBruxellesBelgium

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