Rarely, valproate can produce a fine resting, postural or kinetic tremor. Tricyclic antidepressants infrequently produce a tremor of the upper extremities. Alcohol withdrawal is a well known source of generalized tremor. Caffeine is generally believed to enhance tremor, but quantitative studies have failed to demonstrate that caffeine causes tremor. Theophylline may contribute to increased tremor.
Nicotine increases the amplitude ofphysiologic tremor.
Synthroid and thyrotoxicosis increase tremor. Cardiac antiarrhythmic drugs such as lidocaine, procainamide, and arniodarone can produce tremors. Medical Therapy Treatment of ET is usually initiated either with propranolol or primidone. Primidone is the most effective drug for the treatment of essential tremor if one excludes alcohol. It also produces sedative side effects.