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Published on: December 13, 2017
β-Blocker-Induced Tremor.
Duha M Al-Shorafat1, Suvorit Bhowmick1, Alberto J Espay2
1The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, Department of Medicine University of Toronto Toronto Ontario Canada.
Beta-blockers with partial agonist activity can worsen tremor. This study reports two cases where pindolol and labetalol induced or exacerbated tremor, highlighting a potential side effect of these medications.
Area of Science:
- Pharmacology
- Neurology
- Clinical Medicine
Background:
- Beta-blockers are common tremor treatments.
- Beta-blockers with partial beta-agonist activity may paradoxically worsen tremor.
- This study investigates this potential adverse effect.
Observation:
- A 38-year-old man experienced worsening upper extremity tremor after starting pindolol for depression.
- A 77-year-old woman developed new bilateral hand tremor while taking labetalol for hypertension.
- Both patients showed tremor improvement after medication discontinuation.
Findings:
- Beta-blockers possessing partial beta-agonist activity can induce or exacerbate tremor.
- Pindolol and labetalol were implicated in the observed tremor.
- Cessation of these agents led to tremor attenuation.
Implications:
- Clinicians should consider the potential for tremor induction by certain beta-blockers.
- Patients experiencing new or worsening tremor while on these medications should be evaluated.
- This highlights the importance of medication review in tremor management.
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