Is atenolol (beta blocker) effective in treating essential tremor?

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Last updated: April 29, 2025View editorial policy

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From the Guidelines

Atenolol is not the preferred beta-blocker for treating essential tremor, as propranolol and possibly metoprolol have been found to be effective, but there is no direct evidence supporting the use of atenolol for this condition. When considering treatment for essential tremor, beta-blockers are an option, but the choice of medication should be based on the individual patient's needs and medical comorbidities. According to a 2022 study published in the journal Hypertension 1, propranolol has been used to treat essential tremor for more than 40 years, and other beta-blockers like metoprolol may also be effective depending on the case. Key points to consider when treating essential tremor with beta-blockers include:

  • The typical starting dose and potential side effects, although specific to propranolol, can be considered when evaluating the use of other beta-blockers
  • Patients should be closely monitored for any adverse effects, especially those with certain medical conditions like asthma, diabetes, or heart problems
  • The effectiveness of beta-blockers for essential tremor can vary depending on the individual patient and the specific medication used. Given the lack of direct evidence supporting the use of atenolol for essential tremor, it is recommended to consider alternative beta-blockers like propranolol or metoprolol, which have a more established history of use for this condition.

From the Research

Atenolol as a Treatment for Essential Tremor

  • Atenolol is mentioned as a possible alternative to propranolol in the treatment of essential tremor, in case patients experience adverse effects with propranolol 2.
  • The effectiveness of atenolol in treating essential tremor is classified as "probably effective" 3.
  • However, the most robust evidence supports the efficacy of propranolol, primidone, and topiramate (>200 mg/day) in treating essential tremor, with atenolol not being mentioned among the most effective options 4.
  • The current status of essential tremor treatment prioritizes propranolol or primidone as the first line of treatment, with atenolol not being mentioned as a primary option 5.
  • A review of current and future neuropharmacological options for essential tremor mentions propranolol and primidone as the most effective drugs, with atenolol not being discussed as a primary treatment option 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Update on treatment of essential tremor.

Current treatment options in neurology, 2013

Research

MDS evidence-based review of treatments for essential tremor.

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

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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