WEDNESDAY, Oct. 19 (HealthDay News) -- An antiseizure drug
called primidone (Mysoline) and a high blood pressure drug called
propranolol (Inderal) are the most effective medicines to treat
shaking in people with essential tremor, according to an updated
treatment guideline from the American Academy of Neurology.
Essential tremor, which affects about 10 million people in the
United States, is the most common type of tremor disorder and is
often mistaken with other movement disorders such as Parkinson's
The condition usually starts after age 40 and affects the hands,
head and voice. It can cause difficulties with daily activities
such as eating, writing, shaving and sewing.
Along with primidone and propranolol, other helpful medicines
include the antiseizure drugs gabapentin (Fanatrex, Neurontin) and
topiramate (Topamax), the high blood pressure drugs atenolol
(Tenormin) and sotalol (Betapace, Sorine), and the anti-anxiety
drug alprazolam (Xanax), according to the guideline.
Unlike the 2005 guideline, the updated guideline does not
recommend the use of the antiseizure drugs levetiracetam (Keppra)
and flunarizine (Sibelium) or the drug 3,4-diaminopyridine (used
for rare muscle diseases) to treat tremors of the arms and
The new guideline also noted that there is insufficient evidence
to support the use of the schizophrenia drug clozapine (Clozaril).
There is only weak evidence to support the use of the high blood
pressure drugs nadolol (Corgard) and nimodipine (Nimotop), the
antiseizure drug clonazepam (Klonopin), and botulinum toxin A
For patients who don't benefit from drug treatment, two types of
brain surgery -- deep brain stimulation and thalamotomy (involving
the thalamus) -- may prove helpful, the guideline stated.
The guideline, endorsed by the International Essential Tremor
Foundation, is published in the Oct. 19 online edition of the
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