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Survey of medication usage patterns among essential tremor patients: Movement disorder specialists vs. general neurologists
Open accessAbstract
Background Although small treatment trials have examined the efficacy of front-line medications in tremor reduction in essential tremor (ET), an overall survey of pharmacological management has not been undertaken in a large sample of ET cases. Objectives To conduct a survey of medication usage among several hundred ET patients. Methods A computerized database at the Neurological Institute of New York was used to identify 223 ET patients cared for by movement disorder neurologists and 37 cared for by general neurologists. Each had been seen one or more times within past five years. Lifetime treatment data were abstracted from clinical records. Results One-hundred-sixty-three (73.1%) of 223 patients cared for by movement disorder neurologists had taken medication for ET during their lifetime; 53/163 (32.5%) had taken ≥4 medications; 31/163 (19.0%) had taken ≥5 medications; and 3 (1.8%), ≥10 medications. Nearly three-quarters (158/223 [70.9%]) had taken primidone or propranolol, yet 89/158 (56.3%) had discontinued both. Among 11 patients who had undergone ET surgery, the mean number of ET medications tried was 6.0 ± 2.8 (range = 3-12). Medication usage by general neurologists was less than by movement disorder specialists (p < 0.001). One-third of general neurologists' patients (14/37 [37.8%]) had taken primidone or propranolol at some point and 6/14 (42.9%) had discontinued both. Conclusions In this large survey, a substantial proportion of ET patients failed treatment with both front-line medications. Among patients seeing movement disorder specialists, the number of medications they had had to try was sizable. These data demonstrate the limitations of current pharmacological options for ET.
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Up to 56% of essential tremor patients eventually give up propranolol or primidone because of secondary effects or lack of efficacy.
“Moreover, up to 56% eventually give up their use (30) because of these secondary effects or the lack of efficacy.”
From A Review on Wearable Technologies for Tremor Suppression (2021) · cites this paper as [30]
The Results (Patients Cared for By Movement Disorder Neurologists) report that 56.3% of patients who had tried primidone or propranolol were taking neither anymore. They list side effects and lack of efficacy as reasons for stopping each drug, but do not establish that those reasons account for the entire 56.3%. The figure also applies to patients who had tried either drug in the movement-disorder-specialist group, not to essential tremor patients generally. (LLM, conf=0.87)
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References 12 · Cited by 69
Research works printed but not linked: 11
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- Louis, 2010, How are we doing with the treatment of essential tremor (ET)? Persistence of ET patients on medication: data from 528 patients in three settings, Eur J Neurol, 17, 882, 10.1111/j.1468-1331.2009.02926.x · DOI
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Metadata
- Authors
- Diaz, N. L., & Louis, E. D.
- Affiliations
- Columbia University (US)
- Columbia University Irving Medical Center (US)
- ORCID
- Louis, Elan D.
- Venue
- Parkinsonism & Related Disorders
- Publisher
- Elsevier BV
- Published
- 2010-11
- Volume
- 16
- Issue
- 9
- Pages
- 604-607
- ISSN
- 1353-8020 (ISSN-L)
- PMC
- PMC2963696
- OpenAlex
- W2055478460
- Cited by
- 69
- References
- 12
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 10 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Parkinsonism & Related Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (2P01 AG0027232-16)
- National Institute of Neurological Disorders and Stroke (R01 NS 42859, T32NS07153-24, R56NS042859, R01 NS 36630, R01NS042859, R01NS036630, T32NS007153, R01 NS 39422, R01NS039422)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Health Sciences › Medicine › Clinical Neurology › Botulinum Toxin and Related Neurological Disorders
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Keywords
- essential tremor
- MeSH terms
- Adult, Aged, Anticonvulsants, Drug Utilization, Female, Health Surveys, Humans, Male, Middle Aged, Neurology, New York, Practice Patterns, Physicians', Primidone, Propranolol, Specialization, Essential Tremor, Young Adult
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