propranolol + primidone

Propranolol + primidone is a combination pharmaceutical therapy primarily used to treat *essential tremor*. Both agents are considered first-line therapies for this condition. **Propranolol** is a non-selective beta-adrenoceptor antagonist ("beta-blocker") that primarily reduces tremor through inhibition of peripheral muscle spindles and by modulating CNS pathways, although the exact central neuronal mechanisms are still being explored. **Primidone** is a barbiturate-type anticonvulsant whose tremor-reducing effects are believed to result from modulating cation channels within the central nervous system. When used together, propranolol and primidone provide additive efficacy for tremor control, including situations where monotherapy is inadequate, and particularly for limb and head tremor. Dose titration is necessary to minimize adverse effects, which can be more pronounced with primidone, especially at therapy initiation. Combination therapy does not result in increased side effects compared to monotherapy.

Brand names

Mysoline + Inderal

Other names

propranolol and primidoneInderal and Mysoline