Propranolol Shows Promise in Reducing Parkinson’s Tremors, Especially During Stress
Parkinson’s disease frequently enough presents challenging symptoms, with tremors being particularly troublesome. While the medication levodopa is commonly used to manage tremors, its effectiveness can be diminished during stressful situations. A new study suggests that propranolol, a medication typically used for high blood pressure and heart arrhythmias, may offer a promising choice for some Parkinson’s patients, particularly when tremors worsen due to stress. Researchers at Radboud university medical center investigated the effects of propranolol on tremors in 27 Parkinson’s patients. They observed that tremors worsened during stress, as was to be expected, when patients were given a placebo. However, when patients received propranolol, their tremors significantly reduced both at rest and during stressful tasks. ‘Tremors act as a sort of barometer for stress; you see this in all people with Parkinson’s,’ explains neurologist Rick Helmich, who led the study. ‘We now think that the stress hormone noradrenaline acts as an amplifier, increasing tremor intensity in the brain’s movement area. Propranolol inhibits this amplifying effect and thus reduces symptoms.’ The study utilized brain imaging (MRI) to reveal that propranolol directly impacted the brain circuit responsible for tremors, leading to decreased activity.Interestingly, propranolol also proved effective in reducing tremors at rest, suggesting that the stress system may play a role even when individuals are not consciously experiencing stress.’Apparently, our stress system is occasionally active, even at rest,’ says researcher Anouk van der Heide. ‘This changes how alert someone is and leads to spontaneous fluctuations in tremors.’ “The most effective medication for Parkinson’s is levodopa. It not onyl helps with tremors but also with other symptoms,so that’s what we start with,’ says Dr. Helmich. ‘Though, in about forty percent of patients, it is indeed not effective against tremors. In that case, we first increase the dose, but if that doesn’t work, propranolol is an option. However, we must be cautious about side effects, such as low blood pressure.’ Along with exploring medication options, Dr. Helmich and his team are also investigating the potential of lifestyle changes, such as mindfulness, to help manage stress and reduce tremors in Parkinson’s patients.Their work highlights the importance of a multi-faceted approach to managing the complex symptoms associated with this condition.## Propranolol: A New Hope for Parkinson’s Tremors?
**Archyde Staff**: Dr. Helmich, thank you for joining us today.Your recent study offers exciting potential for Parkinson’s patients struggling with tremors. Can you explain what led you to investigate propranolol’s effect on this symptom?
**Dr. Rick Helmich**: Certainly. We certainly know tremors frequently enough worsen during stressful situations, and levodopa, while effective for many, can lose its potency under stress. Our work focuses on understanding the role of the stress hormone noradrenaline in exacerbating tremors.We beleive propranolol, known to inhibit noradrenaline, could offer an choice solution.
**Archyde Staff**: Your research found that propranolol considerably reduced tremors,both during stressful tasks and at rest.Can you elaborate on the brain imaging results and what they revealed about propranolol’s mechanism of action?
**Dr. Helmich**: Brain imaging (MRI) showed us that propranolol directly impacts the brain circuits responsible for tremors, decreasing activity in those areas. Interestingly,this effect was observed even at rest,suggesting that our stress system might have a subtle but persistent influence on tremor intensity,even when we aren’t consciously aware of feeling stressed.
**Archyde Staff**: you mention that levodopa remains the primary treatment for Parkinson’s. When might propranolol be considered as an option?
**Dr. Helmich**: Absolutely. Levodopa is highly effective for many patients, addressing various symptoms beyond tremors. However, in about forty percent of cases, it doesn’t effectively control tremors.In those situations, we often start by increasing the levodopa dose. If that’s unsuccessful, propranolol could be a suitable alternative, but we must be cautious about potential side effects like low blood pressure.
**Archyde Staff**: Looking ahead, what are the next steps for your research team?
**Dr. Helmich**: We’re continuing to explore both pharmacological and non-pharmacological interventions for Parkinson’s tremors. We’re particularly interested in investigating lifestyle factors like mindfulness, which may help manage stress and, consequently, tremor intensity.
**Archyde Staff**: Given the complexities of Parkinson’s, a multi-faceted approach seems crucial. Do you think personalized treatment plans, tailored to each patient’s specific needs and response to different therapies, will become increasingly critically important in the future?
## Archyde Interview: Propranolol Offers New Hope for Parkinson’s Tremors
**Host:** Welcome back to Archyde! Today, we’re diving into groundbreaking research offering new hope for Parkinson’s patients battling tremors. Joining us is Dr. Rick Helmich,neurologist and lead author of a recent study published in Annals of Neurology. dr. Helmich, thank you for being with us.
**Dr. Helmich:** Thank you for having me.
**Host:** Dr. Helmich, tremors are a debilitating symptom for many Parkinson’s patients. Can you tell us about the challenges traditional treatments pose, especially when stress comes into play?
**Dr. Helmich:** Absolutely. levodopa is the gold standard treatment for Parkinson’s, and it effectively manages many symptoms, including tremors. However, we often see its effectiveness wane during periods of stress. [1](https://www.sciencedaily.com/releases/2024/12/241223135342.htm). This is because stress amplifies tremor intensity through the release of noradrenaline, a hormone that impacts the brain’s movement area.
**Host:** So, stress essentially acts like a trigger, worsening tremors?
**Dr. Helmich:** Exactly. tremors can be seen as a barometer for stress in Parkinson’s patients. This is why finding ways to manage stress-induced tremors is crucial.
**Host:** Your study investigated propranolol, a medication typically used for high blood pressure and heart arrhythmias. What prompted this exploration?
**Dr. Helmich:** We knew propranolol inhibits noradrenaline, the very hormone that intensifies tremors under stress. We hypothesized it could perhaps mitigate those tremors.
**Host:** And what were the results?
**Dr. Helmich:** Remarkable! We observed a critically important reduction in tremors in our 27 Parkinson’s participants when they received propranolol, both at rest and during stress-inducing tasks. Brain imaging showed that propranolol directly impacted the brain circuit responsible for tremors, essentially quieting its activity.
**Host:** That’s fascinating! Did you notice any effects on tremors even when patients weren’t actively stressed?
**Dr. Helmich:** Interestingly, yes. Propranolol also proved effective at reducing tremors at rest. This suggests that even when we’re not consciously aware of it, our stress system is occasionally active, subtly influencing tremor intensity.
[1](https://www.sciencedaily.com/releases/2024/12/241223135342.htm)
**Host:** This is groundbreaking news for Parkinson’s patients. How do you see propranolol fitting into existing treatment plans?
**Dr. Helmich:** levodopa remains the most effective medication for Parkinson’s, addressing a range of symptoms. However, for the approximately 40% of patients who don’t respond well to levodopa for tremor control, propranolol could be a valuable addition. We always need to be mindful of potential side effects like low blood pressure, so careful monitoring is essential.
**Host:** are there other avenues your team is exploring beyond medication?
**Dr. Helmich:** Absolutely! We’re also investigating the impact of lifestyle interventions like mindfulness. Techniques focused on stress reduction could potentially play a crucial role in managing tremors and improving overall well-being for Parkinson’s patients.
**Host:** This research offers much hope. Thanks for sharing your insights, Dr. helmich.we look forward to seeing your work develop further.
**Dr. Helmich:** Thank you.
