Final answer:
The first-line treatments for essential tremor are the medications propranolol, a beta-blocker, and primidone, an anticonvulsant. These can be used alone or in combination, with other treatments available for those who do not respond or tolerate the initial medications.
Step-by-step explanation:
The first-line treatment for essential tremor typically includes medications such as propranolol and primidone. Propranolol is a beta-blocker that can help manage the physical symptoms of essential tremor by reducing tremor amplitude. Primidone is an anticonvulsant that is also effective in treating essential tremor. It may be used alone or in combination with propranolol, especially in patients who do not respond to or cannot tolerate propranolol.
Other treatment options that may be considered if medication is not effective or not tolerated include the use of other beta-blockers, benzodiazepines such as alprazolam, and anticonvulsant drugs like topiramate or gabapentin. In some severe cases, surgical interventions such as deep brain stimulation (DBS) may be contemplated.
Ultimately, the treatment plan should be individualized based on the severity of the tremor, the patient's other health conditions, and their response to initial treatments.