Table 2 Treatment options in primary orthostatic tremor
From: Lessons I have learned from my patients: everyday life with primary orthostatic tremor
Drugs/Neurostimulation | Doses | Reported clinical effect |
|---|---|---|
Clonazepam | 0.5 mg- 6 mg /day | Moderate to marked benefit in 50 to 30% of the patients |
Gabapentin | 300–2400 mg/day | Moderate to marked benefit |
Beta-blockers (propranolol | 20–240 mg/day | Little effect of POT. May improve arm postural tremor |
Primidone | 125–250 mg/day | No effect, poor tolerance |
L-Dopa Pramipexolea | 300–800 mg/day | Rare cases (short term benefit)b |
Antiepileptic drugs (valproic acid, phenobarbital, carbamazepine, levetiracetam, topiramate, pregabalin) | Minimal to no effect Few cases. No prolonged treatments | |
cDeep Brain stimulation Spinal cord stimulation | Thalamusc | Rare cases. Variable results. Some increase in time in the upright position. |
Botulinum toxin (tibial anterior) | No beneficial effect |