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Treatments and drugs
By Mayo Clinic staff
Some people with essential tremor may not require treatment if their symptoms are mild. But if your essential tremor is making it difficult to work or perform daily activities, you may want to discuss treatment options with your doctor.
Medications
- Beta blockers. Normally used to treat high blood pressure, beta blockers — such as propranolol (Inderal), atenolol, metoprolol and nadolol — help relieve tremors in some people. They may not be an option if you also have asthma, diabetes or certain heart problems.
- Anti-seizure medications. Epilepsy drugs — including primidone (Mysoline), gabapentin (Neurontin) and topiramate (Topamax) — may be effective in people who don't respond to beta blockers. The main side effects are drowsiness and flu-like symptoms, which usually disappear within a short time.
- Tranquilizers. Doctors sometimes use drugs such as diazepam (Valium) and alprazolam (Xanax) to treat people whose tremors are made much worse by tension or anxiety. Side effects can include confusion and memory loss. Additionally, these medications should be used with caution because they can be habit-forming.
- Botulinum toxin type A (Botox) injections. You're probably familiar with Botox as a treatment for facial wrinkles, but it can also be useful in treating some types of tremors, especially of the head and voice. Botox injections can improve problems for up to three months at a time. But if it's used to treat hand tremors, it can sometimes cause weakness in your fingers.
Therapy
Physical therapy exercises can sometimes reduce tremor and improve coordination and muscle control. Occupational therapists may suggest some of the following adaptive devices to reduce the effect of your tremors on your daily activities:
- Heavier plates, glasses and utensils
- Wrist weights
- Wider writing implements
Surgery
Surgery may be an option for people whose tremors are severely disabling and who don't respond to medications.
The most common procedure is called deep brain stimulation, which involves inserting a long, thin electrical probe into your thalamus — the portion of your brain responsible for causing your tremors. A wire from the probe is tunneled under your skin to your chest, where a pacemaker-like device has been inserted. This device transmits painless electrical pulses to interrupt signals from your thalamus that may be causing your tremors.
