Tremor medication: what works and what to ask your doctor
A shaky hand or head can make simple tasks harder. Some tremors are mild, some get in the way of work or eating. The good news: many medicines and treatments reduce shaking, and you don’t have to try them blindly. Knowing the common options helps you ask the right questions.
Common drug options
If you have essential tremor, two drugs are used most often: propranolol and primidone. Propranolol is a beta blocker that lowers tremor strength for many people, especially when shaking shows during movement. Primidone is an older anti-seizure drug that works for others who don’t respond to propranolol. Expect side effects: propranolol can slow heart rate or lower blood pressure; primidone may cause sleepiness or balance problems.
For tremor from Parkinson’s disease, dopamine-based treatments help. Levodopa is usually the most effective at reducing Parkinsonian tremor. Dopamine agonists and MAO-B inhibitors can also help but may bring nausea, sleepiness, or changes in behavior. Anticholinergic drugs sometimes reduce tremor in younger patients but often cause dry mouth, confusion, and are risky in older adults.
Other medicines sometimes used include gabapentin, topiramate, and benzodiazepines. These are not first choice for everyone, but they can help in specific cases. Botulinum toxin injections are another option for focal tremors—like head or voice tremor—because they weaken the overactive muscles. That can reduce shaking but may cause local weakness.
Practical tips for starting treatment
Before you start any medicine, keep a simple tremor diary. Note when tremor appears, what makes it worse, and how it affects daily tasks. If tremor is intermittent, record a short phone video to show your doctor. Always tell your clinician about other medicines you take; propranolol and many other drugs can interact with common prescriptions.
Start low and go slow with doses. Many side effects fade as your body adjusts, but some mean the drug isn’t right for you. Ask how long until you should expect improvement, what side effects to watch for, and when to call. If you’re driving, working with heavy machines, or caring for others, check whether dose changes affect your ability to stay safe.
If medicines don’t help enough, ask about specialist options. Deep brain stimulation often reduces severe tremor when drugs fail. Focused ultrasound is a newer, non‑invasive choice for selected patients. Both require a movement disorder specialist to evaluate risks and benefits.
If your tremor starts suddenly, gets worse quickly, or comes with weakness, trouble speaking, or vision changes, get urgent care. For slow-onset or long-standing tremor, book time with a neurologist so you can build a tailored plan. With the right treatment and simple lifestyle tweaks, many people see real improvements and regain confidence using their hands again.
Oct, 21 2024