My sister has been prescribed divalproex sod er 500mg each (2 tablets) in the evening. She seems very subdued and not her normal self. She is also taking bupropion hcl xl 150mg in the evening. When I told the psychiatrist that she had some trouble eating because of her tremors, he prescribed 10mg of propranolol twice daily. What do you think?
Hello ! I read your question and understand your concern. Divalproex can be the cause of tremor. I would recommend to have a plasma level of divalproex to rule out overdosage. Although 1000mg/d is not a high dose. If she stops divalproex the tremor probably will stop. But I would take into account the benefits in seizure control of divalproex. It can be switched also into another drug for the seizures, such as lamotrigine, which is better in young females. Propranolol is a drug very effective in tremor , and also safe in this situation. It can cause bradycardia , so the dose must be tapered to patient toleration . So you may choose to continue on divalproex and propranolol or switch into a new drug for seizures. You must consult with your doctor for these options. Hope to have been helpful! Best wishes Dr. Abaz Quka
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How Safe Is Taking Propranolol For Tremors?
Hello ! I read your question and understand your concern. Divalproex can be the cause of tremor. I would recommend to have a plasma level of divalproex to rule out overdosage. Although 1000mg/d is not a high dose. If she stops divalproex the tremor probably will stop. But I would take into account the benefits in seizure control of divalproex. It can be switched also into another drug for the seizures, such as lamotrigine, which is better in young females. Propranolol is a drug very effective in tremor , and also safe in this situation. It can cause bradycardia , so the dose must be tapered to patient toleration . So you may choose to continue on divalproex and propranolol or switch into a new drug for seizures. You must consult with your doctor for these options. Hope to have been helpful! Best wishes Dr. Abaz Quka