Causes and types of tremor 3 of 4

What support and treatments are there?

 

A summary of the types of treatments available for tremor. 

 

 

Drug treatments to help manage tremor

 

Are there drug treatments available to help manage tremor?

There are no drugs specifically for treating MS tremor.   However, some people have found that drugs licensed for treating other conditions can be beneficial in reducing tremor.  

 

Are drug treatments for tremor effective?

 

  Few of the drugs used to treat tremor in MS have been evaluated in trials or studies specifically for tremor in MS and none have been tested in large-scale clinical trials for MS tremor, and some people find little or no benefit.   However, some respond to one drug and others to a combination – it can be a process of trial and error.

 

Your approach to trying drug treatments for tremor will depend on how severe your tremor is, what impact it is having on you and your carers, and what the side effects may be.

 

 

 

Propranolol

 

A drug called Propranolol has been said to reduce tremor for some people when taken in high doses, but this has not been confirmed in clinical trials and its effect can be temporary.   However, for some people, even a small decrease in tremor for a short time may make a significant difference to what they are able to do.

 

Isoniazid

 

Another drug, Isoniazid, can also lessen tremor when taken in high doses, and there is some evidence that it may have a greater effect on postural tremor than on intention tremor.   However, many people find it unpleasant to take as it can cause stomach upset.   Isoniazid must also be taken with another drug, pyridoxine, to help prevent it from causing any damage to peripheral nerves (nerves outside the brain and spinal cord).

 

Clonazepam, Carbamazepine, and Gabapentin

 

Some benefit has been reported from drugs such as Clonazepam, Carbamazepine and Gabapentin but they have not been properly evaluated.   Other drugs with a muscle-relaxing effect have also been tried as treatments for tremor, though with very limited success.   While the evidence is not available to say with any certainty whether or not they will be beneficial, you may want to ask your GP or neurologist whether it would be worth trying them.

 

Steroids

 

When tremor is related to a relapse, steroids may be used to shorten the duration of the relapse.   Steroids do not have an effect either on tremor itself or the progression of MS. 

 

Is there any research into new drug treatments for tremor?

Six small controlled trials over recent years have also reported that cannabis may have a positive effect on MS symptoms including tremor, spasticity, spasms and incontinence.   However, it is important not to over-interpret these results as the trials were too small.   A much larger trial, the Cannabinoids in Multiple Sclerosis (CAMS) trial has now taken place.   It mainly investigated whether cannabis was effective in treating spasticity arising from MS but it also looked at whether cannabis was helpful for tremor and some other MS symptoms.   The results did not show any significant benefit to people with MS with their tremor symptoms, and cannabis remains illegal in the UK.   The MS Society and others have called for further research into the role of cannabis to help treat MS symptoms. 

 

 

 

 

Compliments of:

http://www.mssociety.org.uk