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September 1987

Adjuvant Therapy of Parkinsonian Tremor

Author Affiliations

From the Department of Neurology, Loyola University School of Medicine, Maywood, Ill, and the Hines (Ill) Veterans Administration Hospital.

Arch Neurol. 1987;44(9):921-923. doi:10.1001/archneur.1987.00520210023013

• The effect of long-acting propranolol hydrochloride (160 mg/d), primidone (250 mg at night), and clonazepam (4 mg/d) on the resting, postural, and kinetic component of tremor was investigated in ten parkinsonian patients in a doubleblind crossover design. Tremor was assessed by patient opinion, clinical scoring, and accelerometer recordings. The amplitude and frequency of tremorgrams were determined by spectral analysis. Most patients preferred long-acting propranolol and chose to continue taking the drug. The mean clinical score for resting and postural tremor was significantly decreased by long-acting propranolol but not by primidone or clonazepam. Longacting propranolol reduced the mean amplitude of resting tremor by 70% and the mean amplitude of postural tremor by 50%. Mean tremor amplitudes were not changed by primidone or clonazepam. Tremor frequency was unaltered by the drugs. No side effects occurred with longacting propranolol but adverse reactions were common with primidone and clonazepam. Long-acting propranolol is a useful adjuvant therapy for the tremors associated with Parkinson's disease.

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