Management of essential tremor

Most patients do not need treatment and all that is required is an appropriate explanation. 1 If necessary, use propranolol (first choice) or primidone 4 . A typical starting dose of propranolol is 40 mg bd; many require 120-240 mg/day. 4 If the tremor is only intrusive at times of increased emotional stress, intermittent use of benzodiazepines, e.g. lorazepam, 30 minutes before exposure to the stress may be all that is required. Modest alcohol intake, e.g. a glass of scotch, is very effective.

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