Essential tremor treatment options limited: reviewers

TREATMENT of essential tremor remains difficult, with up to half of all patients failing to respond to the only drug indicated for its therapy, experts say.

The American Academy of Neurology last week released recommendations on pharmacological and surgical treatment of essential tremor following a systematic review of studies up to April 2010.

The study showed the highest level of evidence backed the use of propranolol, the only drug approved for essential tremor treatment, as well as primidone. 

But unfortunately 30–50% of patients will not respond to these first-line drugs, the experts said.

The latest evidence suggested levetiracetam should not be considered for limb tremor due to lack of evidence of benefit, and olanzapine had been linked to the development of parkinsonism, the reviewers said.

There was insufficient evidence on which to make a recommendation on the use of pregabalin, zonisamide or clozapine, they