From the Research
The recommended dose of propranolol for treating tremors is typically 80 mg per day, as this dosage has been shown to significantly reduce tremor amplitude in patients with essential tremor, as demonstrated in the study by 1. This dosage can be adjusted based on individual patient response, with some studies suggesting that doses up to 120-320 mg per day may be necessary for optimal tremor control 2, 3, 4. It is essential to start treatment at a lower dose, especially in elderly patients or those with liver or kidney impairment, and gradually increase as needed and tolerated. Propranolol works by blocking beta-adrenergic receptors, reducing the effect of adrenaline and noradrenaline on the nervous system, thereby decreasing tremor amplitude. The medication can be taken with food to reduce gastrointestinal side effects, and patients should be aware of potential side effects such as dizziness, fatigue, and lowered blood pressure and heart rate, which should be monitored regularly. For optimal tremor control, consistent timing of doses throughout the day is recommended, and some patients may benefit from using the extended-release formulation for once-daily dosing. It is also important to note that propranolol should not be stopped abruptly, as this can lead to rebound symptoms, and dosage should be tapered gradually under medical supervision. In addition to its efficacy in essential tremor, propranolol has also been shown to be effective in controlling lithium tremor, with dosages ranging from 30 to 40 mg daily in divided doses 5. Overall, propranolol is a effective treatment option for patients with tremors, and its dosage should be individualized based on patient response and tolerance. Key points to consider when prescribing propranolol for tremors include:
- Starting with a low dose and gradually increasing as needed and tolerated
- Monitoring for potential side effects such as dizziness, fatigue, and lowered blood pressure and heart rate
- Consistent timing of doses throughout the day
- Avoiding abrupt discontinuation and tapering dosage gradually under medical supervision
- Considering the use of extended-release formulation for once-daily dosing.