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What Are Beta Blockers For Essential Tremors?

In the United States, there are approximately 10 million people with essential tremor. While mild essential tremor can be managed and even reduced with lifestyle changes and physical therapy, medication is often needed to keep severe cases at bay.

Beta blockers, in particular, have been used to treat essential tremor for more than 40 years, with around 50 to 60 percent of patients experiencing noticeable improvements. Originally created to reduce high blood pressure, these medications help people with essential tremor better control their movements, ultimately improving their quality of life.

Although the exact mechanism behind the efficacy of beta blockers is still unknown, many experts believe they can cut off nerve impulses to the muscles responsible for tremors. Overall, while they are unable to eliminate the occurrence of tremors, beta blockers are effective in lessening tremor amplitude and frequency, especially in the hands.

In this article, we will take a look at the different types of beta blockers for essential tremor, the side effects of beta blockers, some alternatives to beta blockers, and more. Finding the right medication and treatment plan is a crucial first step to taking back control of your day-to-day life.


Types Of Beta Blockers Used To Treat Essential Tremor

There are several types of beta blockers used to treat essential tremor today, each with its own side effects and results. Let’s take a closer look at the two most common types of beta blockers used to treat ET: propranolol and metoprolol.


Propranolol is a beta blocker used to treat a wide variety of circulatory rhythm conditions, and it is the only FDA-approved drug for essential tremor. Also known by its brand names Inderal, Hemangeol, and InnoPran, it can be taken on a daily basis or only before special events depending on the dose.

Propranolol has been shown to reduce tremors by up to 50 percent. In a double-blind, controlled study where propranolol was given to patients alongside a placebo, propranolol performed significantly better in reducing essential tremor. However, despite its efficacy, it is important to note that propranolol is best for high-amplitude, low-frequency essential tremor. It is also much more effective for hand tremors as opposed to axial tremors, such as head and voice tremors.

Like with any other medications, you may experience certain acute or chronic side effects when taking propranolol. There is also the possibility of developing a tolerance to the medication. Consult your doctor to make sure you are taking a suitable dose of propranolol and address any questions or concerns you may have.


Metoprolol, also known as Toprol and Lopressor, is another essential tremor medication. It is a beta blocker typically prescribed to patients who cannot tolerate propranolol due to its effect on the lungs, especially those with asthma and chronic obstructive pulmonary disease. It is a valuable alternative to propranolol as it performs similarly in reducing the amplitude of essential tremor.

It is important to let your doctor know if you have any of the below conditions, so they can make the most informed decision on which medication to recommend.

  • Asthma
  • Chronic obstructive pulmonary disease
  • Chronic bronchial conditions
  • Diabetes
  • Heart disease
  • Liver disease
  • Kidney disease
  • Depression

What Are The Side Effects Of Using Beta Blockers For Tremors?

As beta blockers affect the heart and circulatory systems, they may be responsible for a wide range of side effects, from less worrisome issues such as dry mouth to more serious problems like difficulty breathing. While some side effects may go away as your body adjusts, others may continue for as long as you are taking the medication. Contact your medical provider if you experience any side effects, especially if they are persistent or bothersome.

Some side effects of beta blockers for tremors include:


Depression is a common side effect of beta blockers. Beta blockers and other medications that  cross the blood-brain barrier can cause low blood pressure and overall tiredness in certain patients, both of which contribute to a sense of depression.

However, there are also recent studies that show beta blockers for tremors to be linked with a lower risk of depression. Regardless, if you feel a clear change in mood while on beta blockers, let your doctor know right away to see if your dose needs to be adjusted.

Erectile Dysfunction

Erectile dysfunction is a common side effect for male patients who take beta blockers for essential tremor. The low blood pressure and slower heart rate as a result of the medication makes it more difficult to achieve and maintain penile erection during sexual intercourse.


A slower heart rate means that the heart is pumping less oxygen-rich blood to the body. This can make you tired, light-headed, and sluggish. Incorporating more physical activity into your routine may help combat this issue and help you feel more energetic.

In addition to making you feel more tired when awake, beta blockers can also cause changes to your sleeping patterns. Beta blockers for tremors lower melatonin secretion, which can result in insomnia and even vivid dreams.

Slowed heart rate

Beta blockers for tremors reduce the heart’s output of blood and slow down heart rates in order to treat high blood pressure. If you are experiencing discomfort due to a slower heart rate, ask your doctor for ways to safely increase your heart rate.

Alternatives To Beta Blockers For Essential Tremor

While beta blockers for shaking can effectively manage essential tremor for some patients, they aren’t viable for everyone. Not only is there the possibility of harsh side effects that outweigh the benefits, but many people also develop a tolerance to these medications. For propranolol, 12 percent of patients noticed a drop of efficacy after just one year.

If you can’t tolerate beta blockers due to a preexisting health condition or if they simply do not work for you, there are also other medications available to treat essential tremor. Tranquilizers, migraine medications, and anticonvulsants such as primidone are just some of the many options.

However, if you prefer to not use medication at all or wish to supplement your medication for better results, Cala TAPS therapy may be the choice for you. Cala therapy is delivered on the world’s first non-invasive, drug-free, wrist-worn device that provides individualized therapy for essential tremor. It provides tremor relief through electrical stimulation of the peripheral nerve, disrupting the tremor network in the brain. After one 40 minute session wearing Cala therapy, 75 percent of patients noticed improvement in their tremors.

The Cala therapy device is FDA-cleared to aid in the temporary relief of hand tremors. Calibrated to your unique tremor pattern, it reduces the amplitude and frequency of tremors so you can more easily complete essential daily tasks. Speak with your doctor today to see if Cala therapy is right for you.


What medications make essential tremor worse?

Unfortunately, the medications that make essential tremor worse are different for everyone, so it is important to keep your doctor updated on any side effects you are experiencing. How a drug affects essential tremor depends on a large variety of factors, such as your medical history and current health condition.

However, there are certain drugs known to induce involuntary shaking. Some of them include:

  • Nicotine
  • Alcohol
  • Caffeine
  • Seizure medications
  • Mood stabilizers
  • Steroids
  • Stimulants
  • Antidepressants
  • Cancer medications
  • Asthma medications
  • Weight loss medications

What should you avoid when taking beta blockers?

When taking beta blockers for shaking or for high blood pressure, avoid drinking caffeine and alcohol. These substances reduce the efficacy of  beta blockers by counteracting their antiadrenergic effect. You should also refrain from taking any antihistamines, over-the-counter cold medications, and certain antacids when on beta blockers. Alert your doctor before starting any new medications to make sure there aren’t any negative drug interactions.

What is the most common side effect of taking beta-blockers?

Some of the most common side effects of taking beta blockers for tremors include decreased blood pressure, slower heart rate, fatigue, cold extremities, nausea, depression, anxiety, and shortness of breath. Closely monitor your heart rate and blood pressure when on beta blockers. If you believe something is wrong, notify your doctor right away. Unfortunately, some of these side effects will only stop if treatment ceases.

Start Managing Your Essential Tremor With Cala Therapy

Impeding your ability to complete necessary everyday tasks, essential tremor can be hard to deal with. While completely eliminating essential tremor is not yet possible, luckily there is a variety of treatment options that can effectively control its symptoms. Work with your doctor to find the most optimal treatment plan for you, whether that involves medication, therapy, or injections like botox.

Use Cala TAPS therapy by itself or alongside essential tremor beta blockers to better manage essential tremor. As an FDA-cleared, safe, and effective device, Cala therapy is available by prescription for patients diagnosed with essential tremor. Cala therapy effectively reduces essential tremor with no loss of effect over time, improving your quality of life. Talk to your doctor today to see if Cala TAPS therapy is right for you.