Hi, and welcome to our home! I gather you're diagnosed? Tremors are very common in MS, but present one of the hardests symptoms to treat. And tremors can be one of the most disabling problems. It's not uncommon to see tremor in someone who otherwise has good muscle strength. I know from personal experience that tremors are worse in fatigued muscles.
Tremors are symptoms caused by lesions in the cerebellum. Limb ataxia (jerky, ueven movements) and intention tremor (tremor that appears with purposeful movement) have been reported in 45% to 50% of patients with long-standing disease.
There are several drugs that are used in tremors, most of them are "off-label_ for this use, so there are few good studies.
Propranolol (Inderal) is a blood-pressure and cardiac med that is often useful in treating essential tremor (one that has no disease cause) and in cerebellar tremor of MS. But, doses may need to be pretty high and the side effects may limit this.
Primidone (Mysoline), an anticonvulsant can be used and is sometimes helpful. Doses need are less than those used for seizures.
Clonazepam (Klonopin) and diazepam (Valium) can be used. These are sedatives and muscle relaxants and are often useful. They may be used alone or in combination with another class of med. They can be sedating.
Other meds used less often include:
INH (isoniazid), and anti-tuberculosis med can be used in very high doses (3x that used for TB). This runs the risk of liver and bone marrow toxicity, but this may work in the worst kind of tremor - rubral tremor or "rubro." This severe tremor may involve the entire limb, torso and sometimes the entire body. It may be so violent as to prevent any kind of effective movement at all.
Ondansetron (Zofran) is a powerful anti-nausea med used in chemotherapy and other kinds of severe nausea. The dose is quite high, 8mg three times a day, but the cost of this can be prohibitive. Last time I priced Zofran it cost $30 per 4mg tablet. ($180 per day!!)
Buspirone (Buspar) and anti-anxiety med will occasionally be quite helpful in treating tremor.
Typically the doctor and patient must experiment with various combinations of these meds through trial and error.
Tick, I didn't completely understand your question? Are you asking how many meds should you try before you are resigned to just "live with your tremor." If so, I would say it depends on how much the tremors interfere with your life. Then, you have to weigh that against the side effects of the meds.
Anyway, I hope you find a good place here to talk and ask questions.
Tick 123, welcome to our home. I take 2 mg of zanaflex RXd by the neuro, .25 klonapine for anxiety, and Buprofine for my anxiety 300 mg daily, and the GP has now added benztropine .5 mg ( I am only taking half the rxd dose) and my tremors which only started a few months ago have calmed down. Up until the benztrophine was added my tremors seemed to progressing.
So Quix what is this about ...reported in 45% to 50% of patients with long-standing disease., I assume you are saying tremors are not typical to appear in early part of disease. That doesn't sound good for me.
I knew when I wrote that sentence that it could be misconstrued, but by the time I finished typing it I forgot to add the clarification. Ooops.
No, that statistic is meant to say that people acquire tremors along the way. Some people start out with them. But when you look at a group that is made up of people with longstanding disease, about 50% will have tremors of some kind. I you look at all MSers, including those early in the disease, the percentage will be lower. Does that make sense?
I take Inderal for my tremors and am quite pleased with the results. My tremors had been getting worse to the point of interferring in my life. I actually had several people ask if I had Parkinson's. That sent me to the doctor to find out why I had them and what could be done. It took about a week on Inderal and then things started to improve. In fact, I hardly notice the tremor anymore unless I'm doing very fine motor activities.
Thanks 4 the reply well to everyonee. I am on klonipin mysolene phenabaritol and that buspar.. it couldnt be good 4 me. and i will still get them some its embarresing.
I feel that some people feel likeai need a fix or something. guess i will deal with it.even hit wrong keys soo much fun retyping!!! Thanks again tick123 but did have them so bad i would jerk violintly