Treatment:

Treatment may not be necessary unless the tremors interfere with your daily activities or cause embarrassment.

Medicines may help relieve symptoms. How well medicines work depend on the individual patient.

Two medications used to treat tremors include:

• Propranolol, a drug that blocks the action of stimulating substances called neurotransmitters, particularly those related to adrenaline
• Primidone, an antiseizure drug that also control the function of some neurotransmitters

The drugs can have significant side effects.

Side effects of propranolol include:

• Fatigue
• Nose stuffiness
• Shortness of breath (people with asthma should not use this drug)
• Slow heart beat

Side effects of primidone include:

• Drowsiness
• Difficulty concentrating
• Nausea
• Problems with walking, balance, and coordination

Other medications that may reduce tremors include:

• Antiseizure drugs such as gabapentin and topiramate
• Mild tranquilizers such as alprazolam or clonazepam,
• Blood pressure drugs called calcium-channel blockers such as flunarizine and nimodipine.

Botox injections, given in the hand, have been used to reduce tremors by weakening local muscles.

In severe cases, surgery to implant a stimulating device in the brain may be an option.

Expectations (prognosis):

An essential tremor is not a dangerous condition, but some patients find the tremors annoying and embarrassing.

Complications:

Severe essential tremor can interfere with daily activities, especially fine motor skills such as writing. Sometimes the tremors affect the voicebox, which occasionally leads to speech problems.

Calling your health care provider:

Call for an appointment with your health care provider if essential tremor interferes with your ability to perform daily activities.

Call your health care provider if you are being treated for this condition and have side effects from the medication, such as fainting, very slow heart rate, confusion or changes in alertness, lack of coordination, problems walking, and prolonged nausea or vomiting.