If you have developed shaking of your hands, you could have Parkinson's disease which is difficult to treat, or Benign Tremors which is usually easy to treat. You are more likely to have the more serious Parkinson's disease if you have the tremor at rest, a slow heart beat, rigid firm muscles, slowness to remember facts, difficulty speaking normally, depression or sleep disturbances. Benign (Essential) Tremors usually do not need to be treated and early treatment does not prevent this condition from becoming more severe. When benign tremors interfere with daily activities, you can be treated with beta blockers, anticonvulsant, tranquilizers (benzodiazepines), or diuretics (carbonic anhydrase inhibitors).

Parkinson's disease affects one million Americans and is characterized by shaking at rest, moving slowly, rigid muscles, clumsiness of hand movements, burning or aching feet, inability to fall and stay asleep, a stooped posture, expressionless face, soft voice and depression.

Parkinson's disease usually starts after age 40 and worsens with each passing year. Drugs are often effective when they are started but lose their ability to control symptoms with continued use. The disease usually does not shorten life, but it can cause severe disability with sufferers usually unable to keep a job. Available treatments do not delay the progression of disease, they only help to control symptoms. The usual treatment is with drugs that raise brain levels of dopamine such as levodopa, but doctors try to hold off prescribing them because they lose their effect with continued use. The Food and Drug Administration has approved Mirapex (pramipexole), that can be used in place of levodopa, and when used with levodopa, it can reduce need for that drug by 25 percent (1). Another drug, entacapone, when taken with levodopa, can prolong its effect and help to control the shaking of Parkinson's disease for a longer time. Getting extra sleep also helps to control shaking. Most sufferers have their best control when they first wake up (2).

1) Mirapex by Pharmacia and Upjohn Inc.

2) M Merello, A Hughes, C Colosimo, M Hoffman, S Starkstein, R Leiguarda. Sleep benefit in Parkinson's disease. Movement Disorders 12: 4 (JUL 1997):506-508.

Checked 9/12/18