Essential Tremor – Primidone — SCE Neurology MCQ

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ModerateMovement DisordersEssential Tremor – PrimidoneSCE Neurology

A 55-year-old man with essential tremor has inadequate response to propranolol 160 mg daily. What is the next pharmacological option?

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Correct answer: D — Primidone

Primidone is the recommended second-line (or combined) agent for essential tremor with level A evidence. It should be started at very low dose (62.5 mg at night) and titrated slowly. A: Levodopa is for PD. C: Gabapentin has limited evidence. D: Botulinum toxin is for refractory cases. E: Trihexyphenidyl is for dystonia.

Reference: AAN Essential Tremor Practice Parameter (2011)