Treatment tremors associated with

Patients with mild symptoms of alcohol withdrawal do not generally require medication therapy. Benzodiazepines, like diazepam or alprazolam, are the treatment of choice for patients with severe alcohol withdrawal syndromes like delirium tremens. Barbiturates can also be used for this disorder, but are often less prescribed because they are not as safe as benzodiazepines. Both barbiturates and benzodiazepines are effective in treating the anxiety, tremor, insomnia, and hand tremors associated with delirium tremens. 

The antihistamine hydroxyzine is an effective antianxiety agent, but only at doses (-400 mg/day) that produce marked sedation (see Chapter 24). Propranolol and metoprolol, lipophilic fi adrenergic receptor antagonists that enter the CNS, can reduce the autonomic symptoms (nervousness and muscle tremor) associated with specific situational or social phobias but do not appear to be effective in generalized anxiety or panic disorder (see Chapter 10). Similarly, other antiadrener-gic agents, including clonidine, may modify autonomic expression of anxiety but are not demonstrably usfful in the treatment of severe anxiety disorders. 

Antiparkinsoniam. A drug useful in the treatment of the tremors and rigidity associated with Parkinson s disease. 

In 1987 the xanthine derivative theophylline was the most commonly used medication in the treatment of asthma, followed by / 2-agonists, such as albuterol or ter-butaline, and inhaled corticosteroids, for example budesonide or flunisolide. Today, the most frequently used medication is inhaled / 2-agonists and it is expected that these therapy patterns have shifted toward greater use of inhaled corticosteroids [4, 5], Nevertheless, whether used alone or in combination with other therapies, corticosteroids do not consistently abrogate airway inflammation in patients with asthma common side effects associated with this type of drug are increased heart rate, nervousness, tremors, nasal irritation, nausea, and headaches [8, 10, 11],... 

Occasionally, long-term use of lithium is associated with cogwheel rigidity and a parkinsonian tremor (189). More often than not, concurrent or past treatment with an antipsychotic drug is involved. In a review of SSRI-induced extrapyramidal adverse effects, lithium was listed, but not discussed, as a possible risk factor (190). A review of drug-induced parkinsonism provided references to case reports of lithium s occasionally inducing or exacerbating parkinsonism (191). 

Tardive tremor is a hyperkinetic movement disorder associated with chronic neuroleptic drug treatment. It was first described in 1991 as a symmetrical tremor, of low frequency, present at rest and during voluntary movements but most prominent during maintenance of posture, and often accompanied by tardive dyskinesia. Tetrabenazine is the current treatment. Sequential responsiveness to both tetrabenazine and clozapine has been reported (97). 

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