Do they have medications for a 75-year-old woman who shakes really badly but doesn't have Parkinson's?

4 answers | Last updated: Nov 24, 2016
Forgiven asked...

Do they have medications for a 75-year-old woman who shakes really badly but doesn't have Parkinson's?

Expert Answers

Dr. Leslie Kernisan is the author of a popular blog and podcast at She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

It sounds like the person you're concerned about has some kind of tremor (the medical term for regular shaking of a body part), and someone has told you it's not Parkinson’s disease.  There are medications available to treat tremor, but to prescribe the right medication for this woman, more information about what kind of tremor she has is needed, since tremor can be associated with several different conditions. You should also know that some tremors are actually caused by medications, in which case the recommended treatment may be to reduce or remove the drug that induced this side effect.

Before you get medication to treat an older woman with tremor, I would make sure that a doctor has tried to figure out what's causing her to shake.  It's especially important to notice whether the tremor happens when the person is resting, versus standing or in action.  For instance, resting tremors are classic signs of Parkinson's disease, and even if her doctor says it's not Parkinson’s now, it still could either become Parkinson's or be associated with a disease related to Parkinson's. If Parkinson's has already been ruled out by her physician and you remain doubtful of the diagnosis, you can always seek a second opinion.

But most tremors are postural or action tremors, which means the shaking happens when a person holds out an arm, is standing, or is trying to do something like write or point a finger.  If an action tremor is investigated and no particular disease or medication is found to be the cause, then the person is usually diagnosed with what's called essential tremor. 

Essential tremor can be treated with a medication called propranolol, but this drug usually causes lower blood pressure and slower heart rate, both of which can increase the risk of falling for an older person.  Other medications sometimes used to treat essential tremor include anti-seizure drugs such as primidone and gapabentin, but these can also cause problematic side effects in the elderly.

So while there are treatments available to treat tremors, these drugs may lead to problems that are worse than shaking.  I would certainly recommend a physician's evaluation to figure out what's behind the tremor, if that hasn't been done.  One of the questions you'll want to address is how disabling or unsettling the shaking is to the woman concerned. Once these issues have been explored, you and your loved one can talk with her doctor about whether a medication to try to control the shaking might be appropriate. 

Community Answers

Nicky1 answered...

Hi - My mom just transferred from a hospital to a rehab center. She was falling down a lot and the nurse told me her blood pressure has been fluctuating and low. It's different when she sits, stands and lays down. She has Parkinsons and essential tremors. The essential tremors has run in each member of the family on my grandmother's side of the family. She just fractured a leg while falling. Her hands are bad without the medication. Should she check with her doctor re the anti-seizure drugs you discuss above - primidone and gapabentin? Do you have any other suggestions? Thank you, Nicky

Nathanael answered...

What about Huntington's Disease? Or there is another disorder that acts like Parkinson but is not. A relative on my father's side had surgery to put a wire in his brain to control the shaking and immediately the tremors stopped. They left the wire there if his tremors reappeared.

Foolintherain answered...

Does she drink a lot? No offense intended but alcohol withdrawal definitely causes the shakes in which cause a benzo like Librium, valium or ativan would be indicated. A friend of mine was an alcoholic and when he went to jail they gave him Librium obviously because he couldn't get any booze(easily anyway) in jail and acute alcohol withdrawal can be fatal.