A randomized placebo-controlled comparative trial of gabapentin and propranolol in essential tremor.
BACKGROUND
New medication is needed to treat essential tremor. Preliminary evidence suggests that gabapentin may be effective in the treatment of this disorder.


OBJECTIVE
To study the effects of gabapentin in a comparative, double-blind, crossover, placebo-controlled trial of patients who have essential tremor.


METHODS
16 patients with essential tremor (6 with a new onset and 10 with a 2-week washout period of previous treatment with propranolol hydrochloride) received gabapentin (Neurontin), 400 mg 3 times daily; propranolol hydrochloride, 40 mg 3 times daily; and placebo for 15 days with a 1-week washout period between treatments.


METHODS
Major outcome evaluations consisted of a Tremor Clinical Rating Scale, accelerometric recordings, and a self-reported disability scale obtained before drug intake on study days 1 and 15 of each treatment period. In addition, the initial (day 1) and superimposed (day 15) drug effects were studied before and 2, 4, 6, and 8 hours after drug intake.


RESULTS
At day 15, both gabapentin and propranolol demonstrated significant and comparable efficacy in reducing tremor from baseline in all tremor measures. The initial drug effects evaluated through accelerometry revealed no significant changes with the use of a placebo, but gabapentin and propranolol use significantly reduced tremor power.


CONCLUSIONS
Gabapentin may be useful for the treatment of essential tremor.
Gironell
A
A
Department of Neurology, Sant Pau Hospital, Autonomous University of Barcelona, Spain.
Kulisevsky
J
J
Barbanoj
M
M
López-Villegas
D
D
Hernández
G
G
Pascual-Sedano
B
B
D000085:Acetates / Q000627:therapeutic use*; D000284:Administration, Oral; D000368:Aged; D000588:Amines; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003509:Cyclohexanecarboxylic Acids; D004311:Double-Blind Method; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D013565:Sympatholytics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014202:Tremor / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D000978:Antiparkinson Agents; D003509:Cyclohexanecarboxylic Acids; D013565:Sympatholytics; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D011433:Propranolol