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Epilepsy Health Center

Select An Article

Drug Treatments for Essential Tremor

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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.

Botulinum Toxin

Botox (subtype A) and Myobloc (subtype B) are the brand names for botulinum toxin, which can be used to treat some movement problems. The drugs work by weakening muscles to reduce tremor. The drug also can be used to treat voice or head tremors. This treatment involves an injection once every three months.

Do not take this drug if you are pregnant or if you have myasthenia gravis, post-polio syndrome, or Eaton-Lambert syndrome. Side effects of Botox are rare, but may include excessive muscle weakness or loss of appetite.

Are There Alternative Therapies for Essential Tremor?

Currently, there is no evidence that alternative treatments are beneficial in treating essential tremor. Patients who have tremors that worsen with emotional stress may find relaxation therapies helpful at temporarily easing symptoms.

Some herbal supplements may make tremor worse. Always consult your doctor before trying any alternative therapy.

WebMD Medical Reference

Reviewed by Neil Lava, MD on September 03, 2014
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