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Metoprolol and propranolol in essential tremor: a double-blind, controlled study
Journal of Neurology, Neurosurgery, and Psychiatry
|September 1, 1981
Summary
Both propranolol and metoprolol effectively reduce essential tremor magnitude compared to placebo. Metoprolol offers a valuable alternative treatment for essential tremor, with similar efficacy to propranolol.
Area of Science:
- Neurology
- Pharmacology
Background:
- Essential tremor is a common neurological disorder.
- Beta-blockers are frequently used to manage essential tremor symptoms.
Purpose of the Study:
- To compare the efficacy of metoprolol and propranolol in treating essential tremor.
- To investigate the potential mechanisms of action for beta-blockers in tremor reduction.
Main Methods:
- A randomized, double-blind study involving 23 patients with essential tremor.
- Administration of single oral doses of propranolol (120 mg), metoprolol (150 mg), and placebo.
- Assessment of tremor magnitude and heart rate response to standing.
Main Results:
- Both propranolol and metoprolol significantly reduced tremor magnitude compared to placebo.
- The tremor reduction by metoprolol (47%) was comparable to that of propranolol (55%).
- Both drugs effectively antagonized tachycardia on standing to a similar degree.
Conclusions:
- Metoprolol is a viable alternative to propranolol for essential tremor treatment.
- The tremorolytic effect may involve mechanisms beyond peripheral beta-2 blockade.
- Further research is needed to elucidate the exact mode of action, considering potential loss of cardio-selectivity at the tested dose.