Family Nurse Practitioner Exam

Which of the following is recommended as first-line treatment for essential tremor?

1. Propranolol (Inderal)

2. Phenytoin (Dilantin)

3. Amitriptyline (Elavil)

4. Fluoxetine (Prozac)

The correct answer is: Propranolol (Inderal)

Propranolol is recommended as the first-line treatment for essential tremor due to its effectiveness in reducing the frequency and amplitude of tremors. As a non-selective beta-blocker, propranolol works by modulating the physical response to stress and anxiety, which often exacerbates tremors. The mechanism behind its efficacy includes the inhibition of excessive sympathetic nervous system activity, which benefits patients suffering from this condition. In clinical practice, propranolol has shown significant improvements in tremor severity and is particularly effective for patients who also experience anxiety or performance-related tremors. Additionally, its long history of use offers a solid foundation of safety and tolerability profiles, making it an optimal choice for managing essential tremor. The other medications listed—phenytoin, amitriptyline, and fluoxetine—do not have the same level of evidence supporting their use as first-line treatments for essential tremor. Phenytoin is typically utilized for seizure disorders and not primarily for tremors. Amitriptyline, an antidepressant, may have limited effects on tremors and is not specifically indicated for essential tremor management. Fluoxetine, an SSRI, is primarily used to treat depression and anxiety disorders and does not effectively target the underlying