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Medications for essential tremor

Author/s: 
Allison Paige, Samantha S. Moe
Date Added: 
February 23, 2026
Journal/Publication: 
Canadian Family Physician
Publication Date: 
February 1, 2026
URL: 
Medications for essential tremor
Type: 
Meta-analyses, Reviews, and Guidelines
Format: 
Article
DOI (1): 
https://doi.org/10.46747/cfp.7202112
Keywords 
essential tremor
Upper Limb Tremor
propranolol
Sotalol
Metoprolol
Primidone
Topiramate
atenolol
MeSH 
Propranolol
Sotalol
Metoprolol
Primidone
topiramate
atenolol
Tremor
Arm Tremor
Upper Limb Tremor
Essential Tremor

RPR Commentary

A concise review of medications available for the treatment of patients with essential tremor. James W. Mold MD, MPH

Abstract

Clinical question
How effective are β-blockers and other first-line agents for essential tremor?

Bottom line
Older, small randomized controlled trials (RCTs) show that propranolol reduces tremor severity (about 2 points more than placebo on 10- to 15-point scales) and leads to patients feeling “definitely better” in 64% to 100% versus 14% to 20% (placebo) at 2 to 6 weeks. Benefit is seen from 90 mg/day, with 120 to 240 mg/day most studied. Primidone and topiramate may improve function based on limited RCTs.