Lamotrigine in Essential Tremor

Abstract

Abstract We have conducted a preliminary open trial of the effect of lamotrigine in essential tremor. At doses of 6 and 12.5 mg day-' patients showed an improvement in the mean score for the tremor assessed using the functional cup method. At higher doses the improvement was no longer obtained. It is proposed that low doses of lamotrigine may be of value in the treatment of essential tremor. Essential tremor is characterized by one symptom of tremor predominantly of the hands. The tremor consists of two components: a postural tremor and an action tremor, the latter being mainly respon- sible for the disabling nature of the disorder. As the disease progresses, the tremor, which in its early stages can be reduced by treatment with propra- nolol (Koller & Vetere-Overfield 1989; Mally & Stone 1995), clonazepam (Biary & Koller 1989), primidone (O'Brien et a1 1981), phenobarbitone (Findley & Cleeves 1985), acetazolamide (Oles et a1 1989; Busembark et a1 1992) or theophylline (Mally 1989; Mally & Stone 1995), becomes resistant to these drugs, and a large number of clinical trials during the last ten years have attempted to identify effective agents with longer- term therapeutic value. Since most of the drugs effective in the early stages are established anti- convulsants, we decided to determine whether one of the newer antiepileptic agents, lamotrigine, would also be effective. Lamotrigine has therefore been examined both for its ability to decrease the tremor disability of essential tremor, and to estab- lish the optimal dose for treatment.