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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Essential Tremor Despite Taking Gabapentin And Topiramate?

I have Essential Tremor. For many months I took 300 mg Gabapentun - the tremor got worse. For the past two weeks I ve taken Topiramate 25 mg 1 tablet by mouth at evening for a week then 2 tablets...I have spells of extreme tiredness...happily I discovered a half cup of caffinated coffee will bring me back again. The tremor is only very slightly improved. What other options may I discuss with my Dr? Thank you !Margaret Eberle
Sat, 8 Sep 2018
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General & Family Physician,  's  Response
Hi,

Both Gabapentin and Topiramate are appropriate treatments for essential tremor, however the doses are rather low. You could go up as much as 1200 mg a day with Gabapentin, and 400 mg of Topiramate.

However, for patients with essential tremor I usually started with Primidone or Propranolol, and the combination of the two has been said to be even more effective than either one alone. If these medications don't improve it at all, I would ask your doctor to take another look at the diagnosis to make sure you really have essential tremor.

Hope I have answered your query. Let me know if I can assist you further.
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What Causes Essential Tremor Despite Taking Gabapentin And Topiramate?

Hi, Both Gabapentin and Topiramate are appropriate treatments for essential tremor, however the doses are rather low. You could go up as much as 1200 mg a day with Gabapentin, and 400 mg of Topiramate. However, for patients with essential tremor I usually started with Primidone or Propranolol, and the combination of the two has been said to be even more effective than either one alone. If these medications don t improve it at all, I would ask your doctor to take another look at the diagnosis to make sure you really have essential tremor. Hope I have answered your query. Let me know if I can assist you further.