Is bisoprolol (beta blocker) used to treat tremors?

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Last updated: May 12, 2025View editorial policy

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From the Guidelines

Bisoprolol is not primarily used for treating tremors, and propranolol or other beta-blockers like metoprolol are typically considered first for tremor management. Bisoprolol is a beta-blocker medication mainly prescribed for conditions like high blood pressure, heart failure, and angina. While some beta-blockers (particularly propranolol) are commonly used to treat essential tremor, bisoprolol is not typically the first-choice beta-blocker for tremor management, as noted in a study published in Hypertension in 2022 1.

Key Points to Consider

  • Beta-blockers help reduce tremors by blocking the effects of adrenaline on beta receptors in the nervous system and muscles, which can decrease the amplitude of tremors.
  • Propranolol has been used to treat essential tremor for more than 40 years, and other beta-blockers, such as metoprolol, may also be effective depending on the case, as mentioned in the 2022 study 1.
  • Bisoprolol has been shown to have benefits in reducing morbidity and mortality in patients with heart failure, as seen in the 2013 ACCF/AHA guideline for the management of heart failure 1 and a 2002 scientific review in JAMA 1.
  • However, these benefits do not directly relate to its use in treating tremors.

Recommendation

If someone is seeking treatment for tremors, they should consult with their healthcare provider, who might recommend more established tremor treatments such as propranolol, primidone, or other medications depending on the type and cause of the tremor. The most recent and highest quality study, published in 2022 1, does not support the use of bisoprolol as a primary treatment for tremors.

From the Research

Treatment of Tremors

  • The primary treatments for essential tremor are propranolol and primidone, as stated in the study 2.
  • Propranolol is a β-blocker that has been shown to be effective in treating essential tremor, but other β-blockers with partial agonist activity can induce or exacerbate tremor, as reported in the study 3.
  • There is no mention of bisoprolol being used to treat tremors in the provided studies.

Alternative Treatments

  • Topiramate and phenobarbital could be alternative drugs for treating essential tremor, according to certain evidence-based guidelines 4.
  • Botulinum toxin injections may be useful for patients with refractory essential tremor, especially those with head tremor 4, 5.
  • Surgical interventions, such as deep brain stimulation and thalamotomy, may be considered for medication-refractory and functionally disabling tremor 5.

β-Blockers and Tremors

  • β-blockers with partial agonist activity can induce or exacerbate tremor, as shown in the study 3.
  • Propranolol, a β-blocker, is considered one of the most effective treatments for essential tremor, but its efficacy may be limited by side effects and tolerance, as reported in the study 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

MDS evidence-based review of treatments for essential tremor.

Movement disorders : official journal of the Movement Disorder Society, 2019

Research

β-Blocker-Induced Tremor.

Movement disorders clinical practice, 2021

Research

Essential tremor - drug treatments present and future.

Expert review of neurotherapeutics, 2025

Research

Treatment of essential tremor: current status.

Postgraduate medical journal, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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