Essential tremor (ET) is a common yet poorly understood movement disorder that usually becomes worse over time. Because few drugs are effective in treating ET, researchers have continued to search for new medications to decrease symptoms and improve the lives of people with ET.
With the understanding that the drinking of alcoholic beverages (ethanol) often decreases the movements associated with ET, researchers at the
National Institutes of Health performed a preliminary study to evaluate the use of 1-octanol in the treatment of ET. 1-octanol, which has been approved by the
Food and Drug Administration as a food additive, is similar to, but does not produce the same intoxication as, ethanol.
In this study, six patients with ET received a capsule that contained 1-octanol and six received a similar-appearing
placebo capsule (ie, containing water). Researchers measured the patients’ tremor before, as well as at various time points during, the experiment. They found that patients who received 1-octanol did not show signs of intoxication and had a decrease in tremor that lasted for 90 minutes after they had swallowed the capsules; the placebo group showed no reduction in tremor.
The researchers concluded that 1-octanol was effective in treating ET in this small group of patients and that further studies in a larger group of patients are required to assess safety, tolerability, effectiveness, and duration of action of larger doses of 1-octanol.
Bushara KO, Goldstein SR, Grimes GJ, Burstein AH, Hallett M. Pilot trial of 1-octanol in essential tremor.
Neurology 2004;62:122-124.
Several recently published small studies have shown the effectiveness of high doses (100 mg to 400 mg per day) of topiramate (Topamax
®) in treating ET. Dr. Gatto and his colleagues recently added to the body of evidence with their case reports of three patients with ET. These middle-aged patients tolerated well a 50-mg daily dose of topiramate and had clear improvement in symptoms of ET for follow-up periods ranging from 3 to 12 months. The researchers recommended that further
double-blind placebo-controlled studies be conducted to evaluate the optimal dose range of topiramate in the treatment of patients with ET.
Gatto EM, Uribe Roca C, Raina G, Micheli F. Low doses of topiramate are effective in essential tremor: a report of three cases.
Clin Neuropharmacol 2003;26(6):294-296.
