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Drug Treatments for Essential Tremor


Mysoline for Essential Tremor

Mysoline (primidone) is an anti-seizure drug that is also effective for treating essential tremor. It is most useful for people with hand tremor. Although it is not clear how it works, Mysoline appears to be as effective as Inderal, with significant suppression of tremor in most patients. However, as with Inderal, a percentage of people may develop tolerance to the treatment after about a year.

In most cases, Mysoline is given to people who do not tolerate Inderal. Mysoline also can be given in addition to Inderal to improve symptoms.

Side Effects of Mysoline

Mysoline may cause unwanted side effects in the short term (within the first few days of starting treatment); however, these side effects diminish with longer use. Side effects of Mysoline may include:

  • Difficulty walking
  • Dizziness
  • Nausea
  • Sleepiness
  • Confusion
  • Fatigue

Serious complications with the drug are rare but could include blood cell and bone marrow problems. Your health care provider will check your blood counts every six to 12 months to screen for these problems. Mysoline has a drug interaction with phenobarbital, so the drugs should not be taken together.

Before taking Mysoline, be sure to tell your doctor if you:

  • Are pregnant or nursing
  • Are taking any medications (Mysoline may interact with several different types of drugs.)
  • Have kidney or liver problems

In addition, you should avoid alcoholic beverages while taking Mysoline. Do not stop taking the drug suddenly or switch brands without first consulting with your health care provider.

Other Medications Used to Treat Essential Tremor

Topamax (Topiramate)

Topamax is widely used for epilepsy and migraine. Many doctors prescribe it for essential tremor.  It is important to start with a very low dose and slowly increase the dose to avoid sleepiness.  Many patients may experience a feeling of mental dullness or drowsiness and should consult with their doctor about adjusting the dose.  As many as 30% to 40% of people do not tolerate this drug in higher doses.




Experts use Neurontin for short-term treatment of essential tremor affecting the hands, although it is not known how the drug works. In most cases, it is not used in conjunction with other drugs.

Side effects of Neurontin are rare but include:

  • Sedation
  • Walking difficulties
  • Irritability
  • Weight gain


Some people with essential tremor report symptom relief after drinking a glass of wine or a cocktail. The effect usually lasts about an hour, but rebound tremors can occur after this time. It is generally not recommended that you attempt to treat essential tremor symptoms with alcohol.


Benzodiazepines (Xanax, Klonopin, Valium, and Ativan) may help people whose essential tremor is not improved by other drugs. These drugs appear to relieve tremors associated with emotional stress or anxiety. Side effects of benzodiazepines include confusion, memory loss, and sedation. For most people this is not a good long-term solution.

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