Tips and tricks in tremor treatment
- PMID: 39043978
- PMCID: PMC11489236
- DOI: 10.1007/s00702-024-02806-x
Tips and tricks in tremor treatment
Abstract
Tremor, whether arising from neurological diseases, other conditions, or medication side effects, significantly impacts patients' lives. Treatment complexities necessitate clear algorithms and strategies. Levodopa remains pivotal for Parkinson's tremor, though response variability exists. Some dopamine agonists offer notable tremor reduction targeting D2 receptors. Propranolol effectively manages essential tremor and essential tremor plus (ET/ET +), sometimes with primidone for added benefits, albeit dose-dependent side effects. As reserve medications anticholinergics and clozapine are used for treatment of parkinsonian tremor, 1-Octanol and certain anticonvulsant drugs for tremor of other orign, especially ET. Therapies such as invasive deep brain stimulation and lesional focused ultrasound serve for resistant cases. A medication review is crucial for all forms of tremor, but it is particularly important if medication may have triggered the tremor. Sensor-based detection and non-drug interventions like wristbands and physical therapy broaden diagnostic and therapeutic horizons, promising future tremor care enhancements. Understanding treatment nuances is a key for tailored tremor management respecting patient needs and tolerability. Successful strategies integrate pharmacological, non-invasive, and technological modalities, aiming for optimal symptom control and improved quality of life.
Keywords: Tremor; Tremor treatment.
© 2024. The Author(s).
Conflict of interest statement
Franziska Hopfner is funded by the DFG, the Erwin Röver Stiftung and the CurePSP Foundation and receives author fees from Thieme medical publishers and W. Kohlhammer GmbH medical publishers. Carsten Buhmann received royalties from Thieme medical publishers and W. Kohlhammer GmbH medical publishers and fees for lectures and/or honour boards from AbbVie, Bial, Desitin, Kyowa Kirin, Merz, STADA Pharma, TAD Pharma, UCB, and Zambon. Stephan Klebe received honoraria for lectures from Esteve Pharma, Ipsen, AbbVie, Roche, Stadapharm and Bial. Joseph Classen receives or has received funding from DFG, BMBF, royalties from Thieme medical publishers and W. Kohlhammer GmbH medical publishers; honoraria for lectures from AbbVie, Bayer, BIAL, Biogen, Desitin Arzneimittel GmbH, Roche, UCB Pharma, Zambon. David Pedrosa is funded by the European Commission, EITHEalth and the Reinfried Pohl-Stiftung. David Pedrosa received honoraria as a speaker at symposia sponsored by Bial, Boston Scientific Corp., Medtronic, AbbVie Inc., Zambon, and Esteve Pharmaceuticals GmbH. He received payments as a consultant for Boston Scientific Corp and Bayer, and he was awarded a scientific scholarship from Boston Scientific Corp. for a project titled "Sensor-based optimization of Deep Brain Stimulation settings in Parkinson's disease". David Pedrosa had his travel expenses reimbursed by Esteve Pharmaceuticals GmbH and Boston Scientific Corp for attending conferences. Florian Holtbernd has received funding from the DFG and the RWTH Aachen University. He has received travel and conference fees from Abbvie, Bial, Desitin, Abbott, and Zambon. Jiri Koschel has received travel and conference fees from Desitin, Bial Medronic and Zambon. Zacharias Kohl received honoraria for lectures from AbbVie, BIAL, Pfizer, Desitin Arzneimittel GmbH, Stadapharm and Novartis.
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