To the Editor.—
We have observed significant improvement in response to treatment with trazodone hydrochloride in two patients with marked essential tremor.
Report of Cases.—
Case 1.—A 67-year-old man presented with a fiveyear history of progressive action tremor, which had begun to interfere with work, eating, and writing. Due to a prior history of pancreatitis, he had been advised not to drink alcohol. Physical examination findings demonstrated action tremor at a frequency of 8 to 9 Hz but without gait disturbance, nystagmus, or dysequilibrium. A trial of propranolol hydrochloride with a maximum dose of 120 mg/d produced no improvement. A trial of trazodone hydrochloride, 150 mg/d in divided doses, produced improvement in three weeks. The patient reported that he was able to eat without spilling food or drink. Serial handwriting samples documented improvement. A trial without trazodone was marked by deterioration, which reversed with resumption of therapy and persisted over
McLeod NA, White LE. Trazodone in Essential Tremor. JAMA. 1986;256(19):2675–2676. doi:10.1001/jama.1986.03380190045017