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How to manage essential tremor?

Q: I am 43 years old man. For last one year or so I am feeling shaking in my hands while holding objects especially so when I am in company of others. But even if I am at home, I feel as if there is little shaking in hands while holding cup, spoon, bottle, plate, bowl, etc. But at home it is not much compared to what I feel when others are with me. Perhaps when I am with others, I become conscious and feel some kind of nervousness. At times it becomes so bad that I lift the tea cup while having tea together in a gathering while chatting and just keep holding the cup with no courage to take it to my lips, fearing hands will shake and tea will spill. And at this moment I am over conscious about holding cup properly and tightly. This shaking is also there while signing. My father is about 70 years old and having parkinsons disease for last eight years. He is taking drug but his shaking is too much and is virtually bed ridden. Whether parkinsons disease is hereditary in nature, and am I going to get it like my father? Is there any cure of this problem at this stage itself? Whether I can take any medication to overcome this. I take following drugs for high blood pressure which I am having for about eight years or so - Aten 100 mg od, Prodep 20 mg od, Natrilix sr od, Zestril 10mg od. whether any of the above drug can cause shaking problem. I am also feeling skin itching problem in part of body below waist. More so at location of private part including small flaking of skin. Is it also a side effect of any of the above drugs? Whether any change in drugs or life style is required to overcome above problems like change in food habits, walk, etc? I have referred the problem of shaking to couple of doctors who gave me vitamins and neurobion which I had taken for good duration but didnt get much relief. Please advise.

A:By your note it is likely you do not have Parkinsons disease but an entity called Essential tremor. In Parkinsons, there is tremor when hand is resting peacefully at the side, besides tremor when lifting a cup. Also in Parkinsons there is slowing of movement and slow walking and slowness of hand. You do not mention those complaints. Parkinson is usually not hereditary - 95% of cases have no hereditary basis. Rare cases are hereditary. Essential tremor is hereditary. If you have Essential tremor the treatment is Mysoline ¼ tab at night for first 6 days then increase to ½ per day and if you have no asthma or bronchitis, you may try Betacap TR 40mg ½ tab twice a day and increase. I think best would be to see a neurologist and make the diagnosis sure before therapy.

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