The Pharmacological Management of Essential Tremor and Its Long-Term Effects on Patient Quality of Life: A Systematic Review.

Essential tremor (ET) is one of the most prevalent nerve-related movement disorders, most commonly affecting the hands during voluntary movements or while maintaining posture. Unlike tremors in neurodegenerative conditions, ET is not observed at rest. Continued research is essential to optimize treatment strategies and address the unmet need for sustainable, patient-centered therapies that minimize side effects and enhance long-term quality of life (QoL) for individuals with ET. Five medical databases were searched for content relevant to this study's topic, utilizing the guidelines set forth by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). These databases searched include Web of Science, PubMed, Cochrane Library, ScienceDirect, and Google Scholar for publications between 2010 and 2024. The review analyzed studies including adult patients with ET, focusing on efficacy, safety, and QoL outcomes, with priority given to studies from the Middle East or Saudi Arabia. We included 10 studies that met our inclusion criteria for a full review. Based on the studies, pharmacological treatments such as alprazolam, primidone, propranolol, and CX-8998 were found to be efficient in the management of ET. Emerging medications, including CX-8998 and alprazolam, showed mixed results with significant adverse events. Surgical interventions like deep brain stimulation (DBS) demonstrated long-term motor control benefits, although functional declines occurred due to disease progression. Novel approaches like low-intensity focused ultrasound (LIFU), transcutaneous afferent patterned stimulation (TAPS), and incobotulinumtoxinA injections presented promising results with improved tremor control and minimal side effects. In conclusion, pharmacological treatments for ET provide symptomatic relief but are limited by side effects and reduced long-term efficacy, significantly impacting QoL. Surgical and novel therapeutic options offer enhanced motor control and durability of effects, though they are not universally applicable.