Topic: Essential Tremor
Subject: Medicine
Which one of the following is most likely to be of benefit in patients with essential tremor of the hand?

Primidone and propranolol are the cornerstones of maintenance medical therapy for essential tremor. These medications provide good benefit, reducing tremor amplitude in approximately 50-70% of patients. Usually, propranolol is started first in younger patients and primidone is started first in older individuals. Generally, propranolol carries more risk of serious adverse effects in older patients than in younger ones. If the patient has a relative contraindication to propranolol, such as pulmonary disease or heart block, starting with primidone is preferable.
> Medications with unknown effectiveness include benzodiazepines, beta-blockers other than propranolol, calcium channel blockers, clonidine, gabapentin, and isoniazid.