Topiramate in essential tremor

Ondo, William G.; Jankovic, Joseph; Connor, Gregory S.; Pahwa, Rajesh; Elble, Rodger J.; Stacy, Mark; Koller, William C.; Schwarzman, L.; Wu, Shu; Hulihan, Joseph

doi:10.1212/01.wnl.0000200779.03748.0f

Cited by 161 publications

(83 citation statements)

References 18 publications

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“…It has been studied in the largest study for ET so far [50]. Four relevant studies [50][51][52][53] assessed the effect of topiramate in limb tremor, providing evidence for therapeutic benefit [50][51][52][53].…”

Section: Topiramatementioning

confidence: 99%

“…Four relevant studies [50][51][52][53] assessed the effect of topiramate in limb tremor, providing evidence for therapeutic benefit [50][51][52][53]. A placebo-controlled cross-over study in 24 patients using up to 400 mg/d as mono-or adjunct therapy [51] found a significant reduction of tremor subscores.…”

Section: Topiramatementioning

confidence: 99%

“…In contrast, Frima and Grünewald [52] did not find significant differences in favor of topiramate in their double-blind, placebo-controlled, crossover study at doses of 25, 50, or 100 mg daily. Finally, Ondo et al [50] reported a multicenter, double-blind, placebocontrolled, parallel-design trial of topiramate with a 24-week treatment plan. More than 100 patients with moderate-tosevere tremor were enrolled per group, making it the largest study of topiramate so far.…”

Section: Topiramatementioning

confidence: 99%

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The Treatment of Tremor

Schneider

Deuschl

2014

Neurotherapeutics

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Tremor is a hyperkinetic movement disorder characterized by rhythmic oscillations of one or more body parts. It can be disabling and may impair quality of life. Various etiological subtypes of tremor are recognized, with essential tremor (ET) and Parkinsonian tremor being the most common. Here we review the current literature on tremor treatment regarding ET and head and voice tremor, as well as dystonic tremor, orthostatic tremor, tremor due to multiple sclerosis (MS) or lesions in the brainstem or thalamus, neuropathic tremor, and functional (psychogenic) tremor, and summarize main findings. Most studies are available for ET and only few studies specifically focused on other tremor forms. Controlled trials outside ET are rare and hence most of the recommendations are based on a low level of evidence. For ET, propranolol and primidone are considered drugs of first choice with a mean effect size of approximately 50 % tremor reduction. The efficacy of topiramate is also supported by a large double-blind placebocontrolled trial, while other drugs have less supporting evidence. With a mean effect size of about 90 % deep brain stimulation in the nucleus ventralis intermedius or the subthalamic nucleus may be the most potent treatment; however, there are no controlled trials and it is reserved for severely affected patients. Dystonic limb tremor may respond to anticholinergics. Botulinum toxin improves head and voice tremor. Gabapentin and clonazepam are often recommended for orthostatic tremor. MS tremor responds only poorly to drug treatment. For patients with severe MS tremor, thalamic deep brain stimulation has been recommended. Patients with functional tremor may benefit from antidepressants and are best be treated in a multidisciplinary setting. Several tremor syndromes can already be treated with success. But new drugs specifically designed for tremor treatment are needed. ET is most likely covering different entities and their delineation may also improve treatment. Modern study designs and long-term studies are needed.

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Section: Topiramatementioning

confidence: 99%

Section: Topiramatementioning

confidence: 99%

Section: Topiramatementioning

confidence: 99%

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The Treatment of Tremor

Schneider

Deuschl

2014

Neurotherapeutics

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“…Severe cases cause substantial disability, especially in the elderly, and, if medications such as propranolol, primidone, and topiramate fail, patients may require surgical treatment with deep brain stimulation (2,3).…”

mentioning

confidence: 99%

A functional variant of the dopamine D ₃ receptor is associated with risk and age-at-onset of essential tremor

Jeanneteau

Funalot

Jankovic

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

175

120

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Familial essential tremor (ET), the most common inherited movement disorder, is generally transmitted as an autosomal dominant trait. A genome-wide scan for ET revealed one major locus on chromosome 3q13. Here, we report that the Ser9Gly variant in the dopamine D 3 receptor gene (DRD3), localized on 3q13.3, is associated and cosegregates with familial ET in 23 out of 30 French families. Sequencing revealed no other nonsynonymous variants in the DRD3-coding sequence and in the first 871 bp of the 5 flanking region. Moreover, Gly-9 homozygous patients presented with more severe and͞or earlier onset forms of the disease than heterozygotes. A replication study comparing 276 patients with ET and 184 normal controls confirmed the association of the Gly-9 variant with risk and age-at-onset of ET. In human embryonic kidney (HEK) 293-transfected cells, the Gly-9 variant did not differ from the Ser-9 variant with respect to glycosylation and to anterograde and retrograde trafficking, but dopamine had an affinity that was four to five times higher. With the Gly-9 variant, the dopamine-mediated cAMP response was increased, and the mitogen-associated protein kinase (MAPK) signal was prolonged, as compared with the Ser-9 variant. The gain-of-function produced by the Gly-9 variant may explain why drugs active against tremor in Parkinson's disease (PD) are usually not effective in the treatment of ET and suggests that DRD3 partial agonists or antagonists should be considered as novel therapeutic options for patients with ET.dopamine receptor ͉ gain-of-function ͉ gene dosage ͉ movement disorder ͉ polymorphism

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“…Topiramate is effective in the treatment of moderate to severe essential tremor (Level B). Functional improvements accompany tremor reduction, such as in motor tasks, writing, and speaking [28]. The most common treatment-limiting adverse events in topiramate-treated patients are paresthesia, nausea, concentration/attention difficulty, and somnolence.…”

Section: Criteria For Possible Etmentioning

confidence: 99%

Essential Tremor: A Comprehensive Overview

Shah¹

2017

Journal of Neurological Disorders

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Topiramate in essential tremor

Abstract: Topiramate was effective in the treatment of moderate to severe essential tremor. Tremor reduction was accompanied by functional improvements, such as in motor tasks, writing, and speaking.

Cited by 161 publications

References 18 publications

The Treatment of Tremor

The Treatment of Tremor

A functional variant of the dopamine D ₃ receptor is associated with risk and age-at-onset of essential tremor

Essential Tremor: A Comprehensive Overview

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Topiramate in essential tremor

Abstract: Topiramate was effective in the treatment of moderate to severe essential tremor. Tremor reduction was accompanied by functional improvements, such as in motor tasks, writing, and speaking.

Cited by 161 publications

References 18 publications

The Treatment of Tremor

The Treatment of Tremor

A functional variant of the dopamine D 3 receptor is associated with risk and age-at-onset of essential tremor

Essential Tremor: A Comprehensive Overview

Contact Info

Product

Resources

About

A functional variant of the dopamine D ₃ receptor is associated with risk and age-at-onset of essential tremor