title: Octanoic acid in alcohol-responsive essential tremor: a randomized controlled study.
abstract: OBJECTIVE
  To assess safety and efficacy of an oral, single, low dose of octanoic acid (OA) in subjects with alcohol-responsive essential tremor (ET).
  
  
  METHODS
  We conducted a double-blind, placebo-controlled, crossover, phase I/II clinical trial evaluating the effect of 4 mg/kg OA in 19 subjects with ET. The primary outcome was accelerometric postural tremor power of the dominant hand 80 minutes after administration. Secondary outcomes included digital spiral analysis, pharmacokinetic sampling, as well as safety measures.
  
  
  RESULTS
  OA was safe and well tolerated. Nonserious adverse events were mild (Common Terminology Criteria for Adverse Events grade 1) and equally present after OA and placebo. At the primary outcome, OA effects were not different from placebo. Secondary outcome analyses of digital spiral analysis, comparison across the entire time course in weighted and nonweighted accelerometry, as well as nondominant hand tremor power did not show a benefit of OA over placebo. The analysis of individual time points showed that OA improved tremor at 300 minutes (dominant hand, F = 5.49, p = 0.032 vs placebo), with a maximum benefit at 180 minutes after OA (both hands, F = 6.1, p = 0.025).
  
  
  CONCLUSIONS
  Although the effects of OA and placebo at the primary outcome were not different, secondary outcome measures suggest superiority of OA in reducing tremor at later time points, warranting further trials at higher dose levels.
  
  
  METHODS
  This study provides Class I evidence that a single 4-mg/kg dose of OA is not effective in reducing postural tremor in patients with ET at a primary outcome of 80 minutes, but is effective for a secondary outcome after 180 minutes.
authors: Human Motor Control Section, National Institutes of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA. dietrich.haubenberger@meduniwien.ac.at
authors: Dietrich
authors: D
authors: Haubenberger
authors: Gayle
authors: G
authors: McCrossin
authors: Codrin
authors: C
authors: Lungu
authors: Elaine
authors: E
authors: Considine
authors: Camilo
authors: C
authors: Toro
authors: Fatta B
authors: FB
authors: Nahab
authors: Sungyoung
authors: S
authors: Auh
authors: Peter
authors: P
authors: Buchwald
authors: George J
authors: GJ
authors: Grimes
authors: Judith
authors: J
authors: Starling
authors: Gopal
authors: G
authors: Potti
authors: Linda
authors: L
authors: Scheider
authors: Daniel
authors: D
authors: Kalowitz
authors: Daniel
authors: D
authors: Bowen
authors: Andrea
authors: A
authors: Carnie
authors: Mark
authors: M
authors: Hallett
mesh_terms: D000434:Alcoholic Beverages; D002210:Caprylates / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D020329:Essential Tremor / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013995:Time
chemical_list: D002210:Caprylates; C031492:octanoic acid