A double-blind placebo-controlled trial of topiramate treatment for essential tremor.

The safety and efficacy of topiramate (400 mg/d or maximum tolerated dose) as monotherapy or adjunctive treatment of essential tremor were investigated in a placebo-controlled, crossover study (n = 24). Topiramate resulted in significantly greater reductions from baseline based on normalized scores for a clinical rating of tremor location/severity, specific motor tasks/functional disabilities, and tremor-resultant functional disabilities. Most common adverse events were appetite suppression/weight loss and paresthesias.