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Dose-Response Relationship of Propranolol in the Treatment of Essential Tremor

Dose-Response Relationship of Propranolol in the Treatment of Essential Tremor Abstract • 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. References 1. Larsen TA, Calne DB: Essential tremor . Clin Neuropharmacol 1983;6:185-206.Crossref 2. Koller WC: Diagnosis and treatment of tremors . Neurol Clin 1984;2:499-514. 3. Nies A, Shand DG: Clinical pharmacology of propranolol . Circulation 1975;52:6-15.Crossref 4. Koller WC, Royse VL: Time course of a single oral dose of propranolol in essential tremor. Neurology, in press. 5. Elkins R, Rosenberg BJ: A radioreceptor assay for propranolol and other β-adrenergic blockers . Clin Chem 1983;29:1275-1276. 6. Marsden CD, Jefferson D, Leigh N, et al: Plasma propranolol in essential tremor . Ann Neurol 1982;11:107.Crossref 7. Young RR: Essential-familial tremor and other action tremors . Semin Neurol 1982;2:386-391.Crossref 8. Prichard BNC, Gillam PMS: Treatment of hypertension with propranolol . Br Med J 1969;1:7-16.Crossref 9. Atsman B, Blum I, Wijsenbeck H: The short-term effects of adrenergic-blocking agents in a small group of psychotic patients . Psychiatr Neurol Neurochem 1970;74:251-258. 10. Winkler GF, Young RR: Efficacy of chronic propranolol in action tremor of the familial, senile, and essential varieties . N Engl J Med 1974;290:984-988.Crossref 11. Tolosa ES, Loewenson RB: Essential tremor: Treatment with propranolol . Neurology 1975;25:1041-1044.Crossref 12. Teravainen H, Fogelholm R, Larssen A: Effect of propranolol on essential tremor . Neurology 1976;26:27-30.Crossref 13. Murray TJ: Treatment of essential tremor with propranolol . Can Med Assoc J 1972;107:984-986. 14. Sweet KP, Blumberg J, Lee JE, et al: Propranolol treatment of essential tremor . Neurology 1974;24:64-67.Crossref 15. Sorensen PS, Paulson OB, Steiness E, et al: Essential tremor treated with propranolol: Lack of correlation between clinical effect and plasma propranolol levels . Ann Neurol 1981;9:53-57.Crossref 16. Koller WC: Propranolol therapy for essential tremor of the head . Neurology 1984;34:1077-1079.Crossref 17. Calzetti S, Findley LJ, Perucca E, et al: The response of essential tremor to propranolol: Evaluation of clinical variables governing its efficacy on prolonged administration . J Neurol Neurosurg Psychiatry 1983;46:393-398.Crossref 18. Jefferson D, Jenner P, Marsden CD: Relationship between plasma propranolol concentration and relief of essential tremor . J Neurol Neurosurg Psychiatry 1979;42:831-837.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Dose-Response Relationship of Propranolol in the Treatment of Essential Tremor

Koller, William C.
Archives of Neurology , Volume 43 (1) – Jan 1, 1986
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References (20)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1986.00520010038018
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Abstract

Abstract • 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. References 1. Larsen TA, Calne DB: Essential tremor . Clin Neuropharmacol 1983;6:185-206.Crossref 2. Koller WC: Diagnosis and treatment of tremors . Neurol Clin 1984;2:499-514. 3. Nies A, Shand DG: Clinical pharmacology of propranolol . Circulation 1975;52:6-15.Crossref 4. Koller WC, Royse VL: Time course of a single oral dose of propranolol in essential tremor. Neurology, in press. 5. Elkins R, Rosenberg BJ: A radioreceptor assay for propranolol and other β-adrenergic blockers . Clin Chem 1983;29:1275-1276. 6. Marsden CD, Jefferson D, Leigh N, et al: Plasma propranolol in essential tremor . Ann Neurol 1982;11:107.Crossref 7. Young RR: Essential-familial tremor and other action tremors . Semin Neurol 1982;2:386-391.Crossref 8. Prichard BNC, Gillam PMS: Treatment of hypertension with propranolol . Br Med J 1969;1:7-16.Crossref 9. Atsman B, Blum I, Wijsenbeck H: The short-term effects of adrenergic-blocking agents in a small group of psychotic patients . Psychiatr Neurol Neurochem 1970;74:251-258. 10. Winkler GF, Young RR: Efficacy of chronic propranolol in action tremor of the familial, senile, and essential varieties . N Engl J Med 1974;290:984-988.Crossref 11. Tolosa ES, Loewenson RB: Essential tremor: Treatment with propranolol . Neurology 1975;25:1041-1044.Crossref 12. Teravainen H, Fogelholm R, Larssen A: Effect of propranolol on essential tremor . Neurology 1976;26:27-30.Crossref 13. Murray TJ: Treatment of essential tremor with propranolol . Can Med Assoc J 1972;107:984-986. 14. Sweet KP, Blumberg J, Lee JE, et al: Propranolol treatment of essential tremor . Neurology 1974;24:64-67.Crossref 15. Sorensen PS, Paulson OB, Steiness E, et al: Essential tremor treated with propranolol: Lack of correlation between clinical effect and plasma propranolol levels . Ann Neurol 1981;9:53-57.Crossref 16. Koller WC: Propranolol therapy for essential tremor of the head . Neurology 1984;34:1077-1079.Crossref 17. Calzetti S, Findley LJ, Perucca E, et al: The response of essential tremor to propranolol: Evaluation of clinical variables governing its efficacy on prolonged administration . J Neurol Neurosurg Psychiatry 1983;46:393-398.Crossref 18. Jefferson D, Jenner P, Marsden CD: Relationship between plasma propranolol concentration and relief of essential tremor . J Neurol Neurosurg Psychiatry 1979;42:831-837.Crossref

Journal

Archives of Neurology – American Medical Association

Published: Jan 1, 1986

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