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Provided no side effects, to what dose do you increase propranolol or primidone before considering them ineffective for a patient with essential tremor?

2 Answers
Mednet Member
Mednet Member
Neurology · Northside Hospital
Answered on · Updated on

If tolerated maximum dose of 250 mg of Primidone bid would be acceptable.

This is my personal experience.

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Mednet Member
Mednet Member
Neurology · Kaiser Permanente
Answered on
  1. I’ll increase propranolol up to 30mg bid but only if patients clearly understand the expected decrease in BP and possible lightheadedness. I make sure they have access to BP cuff. It rarely requires this high a dose.
  2. Re mysoline: it causes most patients drowsiness but I advise starting with half pi...

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