β受体阻滞剂所致震颤
β-Blocker-Induced Tremor.
作者信息
Al-Shorafat Duha M, Bhowmick Suvorit, Espay Alberto J, Fasano Alfonso
机构信息
The Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Division of Neurology, Department of Medicine University of Toronto Toronto Ontario Canada.
James J. and Joan A. Gardner Center for Parkinson's Disease and Movement Disorders, UC Gardner Neuroscience Institute, Department of Neurology University of Cincinnati Cincinnati Ohio USA.
出版信息
Mov Disord Clin Pract. 2021 Mar 13;8(3):449-452. doi: 10.1002/mdc3.13176. eCollection 2021 Apr.
BACKGROUND
Although the β-blocker propranolol is considered one of the most effective tremor treatments and other β-blockers are often prescribed to patients with tremor, those with partial β-agonist activity on β-adrenoreceptors can theoretically induce or exacerbate tremor. Here we report 2 patients with tremor induced or worsened by such β-blockers.
CASES
Case 1 is a 38-year-old man with worsening of tremor in both upper extremities after the introduction of pindolol as an adjunct treatment for severe depression. The tremor improved 1 month after discontinuing this medication. Case 2 is a 77-year-old woman with new bilateral hand tremor after receiving labetalol for the management of hypertension during a hospital admission. Tremor markedly attenuated after eliminating labetalol.
CONCLUSION
β-Blockers with partial agonist activity can induce or exacerbate tremor.
背景
尽管β受体阻滞剂普萘洛尔被认为是最有效的震颤治疗药物之一，且其他β受体阻滞剂也常被开给震颤患者，但那些对β肾上腺素能受体具有部分激动剂活性的药物理论上可诱发或加重震颤。在此，我们报告2例由这类β受体阻滞剂诱发或加重震颤的患者。
病例
病例1是一名38岁男性，在引入吲哚洛尔作为重度抑郁症的辅助治疗药物后，双上肢震颤加重。停用该药物1个月后震颤改善。病例2是一名77岁女性，在住院期间接受拉贝洛尔治疗高血压后出现新的双侧手部震颤。停用拉贝洛尔后震颤明显减轻。
结论
具有部分激动剂活性的β受体阻滞剂可诱发或加重震颤。
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