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Abstract Details

Treatment Patterns in Patients with Essential Tremor
Movement Disorders
P15 - Poster Session 15 (12:00 PM-1:00 PM)
3-006
To identify the patterns of pharmacological management of essential tremor (ET)
ET is the most common movement disorder, with a prevalence of about 5% in general population, rising to over 20% in elderly. Although first line therapies for tremor reduction are well identified from small clinical trials, treatment response to these medications is variable. We conducted a survey of pharmacological management in a large sample of ET cases.
The Movement Disorders Clinical Case Registry (MD-CCR) is an application that works within a specific US Veterans Health Administration medical center’s electronic medical record (EMR) to query and export information. The MD-CCR in Houston was queried for all patients with ICD-9/10 codes of 333.1 and/or G25.0 seen in a movement disorder specialty center’s outpatient clinics during the time period September 1, 2001 – March 31, 2018. Each patient’s EMR was reviewed to verify the diagnosis of ET and to find information on medication use.
Of 1468 charts reviewed, 1051 (71.6%) had evidence of ET in the EMR, including information on treatment provided. In the entire ET population, 27% did not receive any treatment due to patient preference and/or non-disabling symptoms. From those who were treated, 43% of the patients were treated with monotherapy, 21% with two medications, 7% with three medications, and 2% with four or more medications. Primidone was the most commonly prescribed treatment (46%) followed by propranolol (37%), topiramate (10%), gabapentin (3%), and benzodiazepines (2%). Medication response (no response, mild, moderate, or significant) was available for 1032 prescriptions, out of which 22% had no response and 11.6% experienced side effects leading to discontinuation.
In this large survey, monotherapy with one of the first line agents (propranolol or primidone) was the most prescribed treatment but with variable efficacy and tolerability requiring either an alternate tremor medication or combination therapy.
Authors/Disclosures
Chintan Shah, MD
PRESENTER 		No disclosure on file
Fariha Jamal No disclosure on file
George R. Jackson, MD, PhD (MEDVAMC) Dr. Jackson has nothing to disclose.
Aliya Sarwar, MD (Baylor College of Medicine/ MEDVAMC) Dr. Sarwar has received personal compensation in the range of $500-$4,999 for serving as a Amneal Fellowship Director Advisory Board Member with Amneal -Rytary.