Clinical and electromyographic characteristics of tremor in patients with generalized anxiety disorder.

The tremor in patients with anxiety was supposed to be an enhanced physiological tremor. However no detailed clinical and electromyographic examination of tremor in patients with anxiety has been published. It has been also supposed that propranolol or benzodiazepines may influence the tremor The aim of this investigation was to establish the clinical and electromyographic pattern of tremor in patients with anxiety and to compare the effects of propranolol and alprazolam treatment. One hundred and twenty patients with tremor and generalized anxiety disorder were investigated. Tremor was scored clinically by the Webster Tremor Scale. Electromyographic examination of tremor activity from antagonistic hand muscles was performed. Sixty patients were treated with alprazolam and propranolol, in an open, crossover design, while the other sixty patients received no particular treatment for the tremor The patients were randomly assigned to treatment with propranolol, alprazolam, or received no tremor treatment. Our results revealed a postural and kinetic tremor with characteristics of an enhanced physiological tremor. Tremor involved only upper limbs and no other body parts. Treatment with propranolol or alprazolam had similar favorable effect on tremor. In conclusion tremor in generalized anxiety disorder is an enhanced physiological tremor The kinetic tremor disturbs patients and particular tremor treatment with propranolol or alprazolam should be applied.