Clinical trial shows propranolol reduces tremors in Parkinson's disease

Medical Xpress / Radboud University / Annals of Neurology ^ | Dec. 23, 2024 | Anouk van der Heide et al

[ConservativeMind]

The standard medication levodopa does not always work against tremors in Parkinson's disease, especially in stressful situations. Propranolol, however, does work during stress, providing insight into the role of the stress system in tremors. MRI scans reveal that propranolol directly inhibits activity in the brain circuit that controls tremors. Doctors may consider this medication when levodopa is ineffective.

People with Parkinson's disease report that tremors worsen during stressful situations.

The commonly used drug levodopa usually helps with tremors, but it tends to be less effective during stress, when tremors are often at their worst.

The medication in question, propranolol, is a beta-blocker that inhibits the action of stress hormones. It was developed for high blood pressure and heart arrhythmias, has been around for a long time, and is already used as a standard treatment for essential tremor.

Helmich and his team studied 27 people with Parkinson's who experienced tremors. They were given propranolol on one day and a placebo on another day.

The study showed propranolol reduced tremors both at rest and during stress. The MRI scans revealed how this works: after taking the medication, the brain circuit responsible for tremors showed less activity.

It surprised the researchers that propranolol also worked to reduce tremors at rest. "Apparently, our stress system is occasionally active, even at rest," says researcher Anouk van der Heide.

Helmich already prescribes propranolol for some Parkinson's patients. "The most effective medication for Parkinson's is levodopa. It not only helps with tremors but also with other symptoms, so that's what we start with," Helmich explains.

"However, in about 40% of patients, it is not effective against tremors. In that case, we first increase the dose, but if that doesn't work, propranolol is an option. However, we must be cautious about side effects, such as low blood pressure."

[ConservativeMind]

Propranolol helps Parkinson’s patients when levodopa may not, which may occur up to 40% of the time.

It is a commonly available drug.

[ConservativeMind]

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[BookmanTheJanitor]

I developed essential tremor at a very young age and was teased about it in school. As a young adult, a doctor put me on propranolol for a heart issue and I noticed that the tremor basically went away. It is a life changer.

[grobdriver]

Bookmark.

[sauropod]

Bkmk

[bgill]

Good to know.

[tinamina]

They prescribe this for stage fright also, so it’s useful in mild anxiety situations as well.

[Does so]

One side effect is diarrhea...

[Ikeon]

Diarrhea? So it’s a weight loss drug too?

[johniegrad]

This has been known for decades.

[dp0622]

Hey I take a beta blocker for high BP

I wake up every morning with tremors due to cerebellum damage some decdaes back.

I take the beta blocker in the morning.

Maybe i should take it before bedtime instead.

Couldn’t hurt

[Delta 21]

There have been several stories lately promoting decades old medications like they are afraid of the new mRna vaccines.(?)

[tinamina]

Oh really I hadn’t heard that one. But from experience I have been using propranolol for at least 10 years and have not experienced that side effect. I used it at first just for blood pressure but I don’t like going over bridges so if I have to go over a big one I take an extra one.