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IMPORTANT SAFETY

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Acute and chronic

effects of propranolol
and primidone in
essential tremor
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Abstract

We studied the acute and chronic e!ects of

propranolol and primidone in essential tremor by
administering long-acting propranolol (80 to 160
mg/d) and primidone (50 to 250 mg/d) to 50
patients. We evaluated patients at 1, 3, 6, 9, and 12
months after treatment and assessed tremor by
subjective rating by patients, clinical scoring, and
tremorgraphic (accelerometer) recordings. Acute
adverse reactions occurred in 8% with propranolol
and 32% with primidone. Propranolol was without
therapeutic e!ect in 30%, and 32% had no benefit
from primidone. Significant chronic side e!ects
occurred in 17% taking propranolol and in 0% with
primidone. Tolerance to drug e!ect occurred with
chronic treatment in 12.5% of patients with
propranolol and 13.0% with primidone. We
conclude that propranolol and primidone are
e!ective long-term treatment for some patients
with essential tremor. Acute adverse reactions with
primidone and side e!ects with chronic use of
propranolol hamper therapy.

© 1989 by the American Academy of

Neurology

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