What are the typical strategies to help improve or manage essential tremor?

The International Parkinson and Movement Disorder Society is a reliable source for information (https://www.movementdisorders.org/)

In general the therapies are organized into:

• Ways to change your movement

• Devices and equipment

• Medications

• Surgeries

For essential tremor, this society has a statement that primodone and propranolol are the most proven to work to treat tremor and should be considered first. Side effects, medication interactions and patient unique risk factors always need to be taken into account. If those do not reduce the tremor enough, options include Topiramate (some evidence) and Gabapentin (less proof it works). There are many other agents people try but are not proven to work.

If tremor does not respond to medicaitons proceures and surgeries can be considered. There are injections with Botulism toxin to weaken the muscles driving the tremor. Surgeries like Deep Brain Stimulation and Thalotomy can silence the nerves creating the tremor.