Effects of Topiramate on Essential Tremor of the Hand, Jaw and Voice

S Adams, M Jenkins, M Jog, A Dykstra


THis study examined the effects of Topiramate on hand, jaw, tongue and vocal essential tremor using instrumental measures, clinical rating scales and patient self-rating scales.  Fourteen patients with essential tremor were evaluated before and after taking 150-350 mg/day of Topiramate, a broad-spectrum anticonvulsant medication, for 6-12 weeks. All fourteen patients had hand tremor.  Eight of these patients also had voice tremor.  Results for the instrumental measures revealed a significant decrease in tremor amplitude for the right index finger, left index finger, jaw and voice (p<.05).  The tremor amplitude for the tongue showed no significant change.  A significant decrease in the clinical rating of tremor severity was obtained for the right upper limb, left upper limb, face, tongue, and voice (p<.05).  Results for patient self-ratings of tremor-related disabilities showed a significant decrease (improvement) for the following activities; eating, hygiene, work, and social (p<.05).  The results of the present study indicate that Topiramate can be associated with improvements in upper limb, oral, and vocal tremor in selected patients.  Future studies are required to compare the efficacy of Topiramate with other more commonly used anti-tremor medications.