Editing Essential tremor (section)

==== Anticonvulsants ====
[[File:Primidone metaboliti.PNG|thumb|chemical structures of primidone and two metabolites, phenobarbital and phenylethylmalonamide]]
[[Primidone]] is another first line agent recommended in the treatment of ET. Primidone is an anticonvulsant which metabolized into phenobarbital and phenylethymalnonamide.<ref name=":0" /> This medication has shown the same beneficial effects in reducing tremors as propranolol and is recommended for use based on guidelines from the American Academy of Neurology and the MDS Task Force on Tremor. The initial dose of primidone is recommended at 25&nbsp;mg per day and should be increased up to the maximum dose of 250&nbsp;mg per day. This strategy was recommended to help avoid the possible side effects of nausea, vomiting, and excessive sedation of primidone.<ref name=":1" /> Primidone is the preferred medication for the treatment of ET in the geriatric population compared to propranolol. In addition, Combination therapy of both Propranolol and Primidone is recommended for people who do not show benefits from either propranolol or primidone as monotherapy.<ref name=":8" />

[[Topiramate]] is an antiepileptic medication which had been studied to assess the efficacy and safety in the treatment of ET.<ref name=":8" /> Overall, it is considered a second-line therapy alone or in combination with other medications when first-line treatments fail to show improvement or medication intolerance. Topiramate has been shown effective in reducing limb tremors at the maximum dose of 200&nbsp;mg, however, there was a higher risk for the development of adverse effects including weight loss, anorexia, cognitive impairment, and kidney stones.<ref name=":1" />