Dose-response relationship of propranolol in the treatment of essential tremor
W. C. Koller
The effect of doses of propranolol hydrochloride, 80 to 800 mg/day, was
investigated in 15 patients with essential tremor. The dose was increased
by 80 mg weekly. Tremor was recorded by an accelerometer and its amplitude
and frequency was determined by spectral analysis. Serum propranolol level
was measured by radioreceptor assay. Tremor control varied greatly from
complete suppression at 80 mg/day to no reduction at 800 mg/day. Mean serum
propranolol levels increased with increasing dosage, but they did not
correlate with tremor suppression. Five patients did not tolerate doses
higher than 640 mg/day. Maximum tremor suppression occurred within a dose
range between 160 and 320 mg/day. Higher doses did not cause additional
tremor reduction.
