Adjuvant therapy of parkinsonian tremor
W. C. Koller and G. Herbster
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 double-blind 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.
Long-acting 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 long-acting 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.
