Help with Tremors

If propranolol or other beta blockers don't help, there are also some seizure drugs that may help. They can either switch you to them or try them in tandem with the beta blocker. For me, propranolol isn't so great and I need high doses (I'm thinking about switching back to nadolol). Otherwise, they may try... -=Antiseizure meds=- • primidone (Mysoline): anticonvulsants (an oldie); has potential for lots of harsh side effects; you'd definitely want to supplement with vitamin D because it will sap your body of it and could cause problems with bone metabolism and whatnot • topiramate (Topamax): great if you need to lose weight (it commonly causes tons of weight loss at the expense of cognitive effects—they don't jokingly call it "Dopamax" for nothing... Lol—but I wasn't lucky to get the weight loss effects and I need it...); watch out for kidney stones with this one • zonisamide (Zonegran): a similar drug to topiramate that I found much more tolerable; may have cognitive effects but most say not as bad as with topiramate; weight loss a common side effect (for some beneficial); kidney stones can be a problem • gabapentin (Neurontin)/pregabalin (Lyrica): not quite as effective and you might want to avoid if you don't want to gain weight; there's theoretically a small chance of dependence as pregabalin is Schedule V -=Benzodiazepines=- Sometimes used, especially when anxiety exacerbates the tremor; the benzos with the most research behind them are: • alprazolam (Xanax) • clonazepam (Klonopin) • diazepam (Valium) • lorazepam (Ativan) (I think?) (Theoretically any benzo might help—they differ in varying potencies at the GABA-A receptor, muscle relaxant properties, sedative properties, etc) -=Other meds=- • nimodipine (Nimotop): a calcium channel blocker used normally to prevent vasospasm secondary to subarachnoid hemorrhage and is no longer used for hypertension (I don't know anything about this med) • clozapine (Clozaril): the prototypical atypical antipsychotic which is used as a medicine of last resort in treatment resistant schizophrenia/schizoaffective disorder or suicidality because if it's potential for very dangerous and potentially life threatening side effects as well as causing seizures, extreme weight gain, and diabetes; they typically use very small doses for tremor but you would probably need weekly blood work at first with this one... There are more they use off-label for but I cannot think of any.

I take propranolol for my tremors and it helps significantly.