Essential Tremor

2 medicines

Essential tremor is the most common movement disorder, causing rhythmic shaking of the hands, head or voice during activity. It is treated first with a beta-blocker such as propranolol.

Inderal

Propranolol

10/20/40/80mg

Inderal is a heart blood pressure medication containing Propranolol, available as 10/20/40/80mg tablets.

from $0.34 / tablet View

Inderal La

Propranolol

40mg

Inderal La is a heart blood pressure medication containing Propranolol, available as 40mg tablets.

from $0.76 / tablet View

Key facts

  • Essential tremor is the most common movement disorder. It causes rhythmic shaking of the hands, head or voice, usually during voluntary movement such as writing or reaching for a cup.
  • Unlike Parkinson's disease, the shaking appears with activity rather than at rest. Genetics plays a large role, and age is the strongest risk factor.
  • First-line treatment is a beta-blocker, propranolol. It reduces tremor amplitude and is part of the wider heart and blood pressure group, though here it is used for its effect on nerve signals rather than blood pressure itself.
  • See a doctor if the tremor worsens suddenly, affects swallowing, or comes with muscle rigidity or slowed movement.

What causes the shaking

The exact mechanism behind essential tremor is not fully understood, but abnormal electrical rhythms in the cerebellum and its connections to the thalamus appear to be central. Genetics play a significant role: roughly half of people with essential tremor have a first-degree relative with the same condition. Age is the strongest risk factor, with prevalence rising sharply after 40 and again after 60.

How essential tremor is treated

Beta-blockers are the most established first-line option. Propranolol reduces tremor amplitude in the hands and is backed by decades of evidence. It works by dampening the sympathetic nerve signals that amplify tremor, even though it is more commonly known as a heart and blood pressure medicine. Neurology specialists may consider anticonvulsants as an alternative for people who cannot tolerate beta-blockers.

Lifestyle changes that help

Practical measures can complement medical treatment: holding objects closer to the body, using weighted utensils, and avoiding caffeine and sleep deprivation all reduce day-to-day impact. Alcohol transiently reduces tremor in many people, though relying on it is not advisable.

When to see a doctor

See a doctor if tremor worsens suddenly, affects swallowing, or is accompanied by muscle rigidity or slow movement, so other neurological conditions can be ruled out.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.