[Clonidine versus propranolol in the treatment of essential tremor. A double-blind trial with a one-year follow-up]

Author(s): Serrano-Duenas M

Affiliation(s): Neurological Service Carlos Andrade Marin Hospital, Quito, Ecuador. serranom@pi.pro.ec

Publication date & source: 2003-06, Neurologia., 18(5):248-54.

Publication type: Clinical Trial; Randomized Controlled Trial

INTRODUCTION: To compare the efficacy of clonidine vs propranolol in the control of essential tremor, a double-blind randomized controlled trial with a one year follow-up was designed to obtain 80 % power and 95 % confidence level. PATIENTS AND METHODS: The participants (186 patients with the essential tremor diagnosis) were recruited from the community, 122 (65.6 %) of these patients completed the trial. They were assessed using a Clinical-Evaluation Scale for Tremor and were examined 5 times, once at baseline and 4 times during the treatment phase. We used ANOVA with Bonferroni corrections, a p> value of 0.01 was considered significant. Dropouts due to side effects were compared using the Fisher's exact X (2) test for two tails, a p>value of 0.05 was considered statistically significant. RESULTS: Propranolol as well as clonidine (p> = 0.005) proved to be statistically efficacious (p> = 0.0005). Propranolol was not more efficacious than clonidine (p> = 0.4). Dropouts were significantly higher in the clonidine group, 22 patients (p> = 0.006) and the most common undesirable side effect in this group was mouth dryness (in 8 patients). CONCLUSIONS: Clonidine was useful; when both drugs were compared propranolol was not shown to be superior to clonidine. Based on the results of this study, clonidine appears to be a good option for the treatment of mild to moderate essential tremor.