Essential Tremor: Are you Self-Medicating with Alcohol?

According to researchers at the U.S. National Institutes of Health, around 80 percent of patients have significant tremor reduction from drinking alcohol.¹

Essential tremor (ET) is no fun. In addition to interfering with daily activities such as buttoning clothes, eating soup, and writing checks, it can bring personal and social emotional trauma. People with ET report feelings of embarrassment, humiliation, isolation, discouragement, frustration and more. It used to be called “benign essential tremor” because it’s not life-threatening. However, its negative impact is anything but benign.

Alcohol has a history of making an impact

Alcohol consumption is probably as old as humanity itself. Evidence of cultures that drank fermented beverages from time immemorial exists practically in all global locations where people settled and had access to fruits, grains and a source of sugar or honey. The Foundation for a Drug-Free World tells us that “Greek literature is full of warnings against excessive drinking.” ²

No doubt, drinking alcohol was also used for medicinal and ritual mood-altering experiences. The fact that beverages like beer and wine were called “spirits” in Shakespeare’s day tells us that alcohol was recognized as having powers to affect body, mind and soul. For untold millennia, people have turned to the power of drink to ease pain – both physical and emotional – and transform their experience, even if only temporarily.

Benefits of alcohol

We know that alcohol can easily be abused, leading to a multitude of ills for an individual or loved ones. While many people make critical judgments about “self medicating” with alcohol, when used appropriately in moderate amounts, it has its benefits. For instance, moderate alcohol use is associated with some protection against heart disease and high blood pressure thanks to antioxidants and a “take-the-edge-off” effect during stress. There’s some evidence that ethanol (the form of alcohol in beer, wine, etc.) “…helps the neurons in the brain resist wear and tear that can lead to Alzheimer’s and dementia later in life.”³ And many people who are socially ill-at-ease find that having a drink upon arriving at a crowded party helps them have a good time and meet new people.

Alcohol and ET

For many individuals with ET, alcohol is a value-added in terms of their quality of life. Researchers Louis & Michalec (2014) acknowledge that ethanol consumption “temporarily lessens the severity of tremor as well as gait abnormalities in patients with essential tremor (ET).”⁴ Because of this, some clinicians have worried that this mild form of self-medicating can easily turn into overuse, placing ET patients in the path of other harms such as liver damage or driving drunk. However, it turns out that patterns of alcohol consumption among those with ET are basically equivalent to those of people without tremors.

Louis & Michalec conducted a clinical-epidemiological study with an enrollment of 354 ET cases and 370 controls. In addition to comparing alcohol use between the two groups, they also sought to correlate severity of ET symptoms with amount of alcohol intake, and finally to learn if familial ET patients had different drinking patterns than non-familial cases.

Here is a brief summary of their chief findings, showing very little difference between ET and non-ET self-reported drinking:

1. 66.7% of ET patients reported alcohol vs. 64.1% of controls
2. 4.0% of ET patients reported heavy drinking vs. 3.5% of controls
3. Average daily intake of alcohol (in grams) was 7.99 for ET patients vs 6.5 for controls (but this was not a statistically significant difference)
4. For those with ET, there was no correlation between severity of symptoms and amount of alcohol intake

The authors concluded, “The absence of a correlation in cases between ethanol consumption and tremor severity goes against the hypothesis that ET patients are self-medicating to a significant degree.”⁵

Not every person with ET will experience reduced tremors through alcohol use. The decision to drink alcohol is personal, whether a person has ET or not. If one chooses to consume alcohol, it should be done in a responsible and sensible manner.

When no medication helps

Just as alcohol does not help many ET patients, neither do prescription medications. About half of ET cases do not respond to medication. Even when drugs help, having to increase the dosage as tremors progress often leads to unpleasant side effects, and use is discontinued.

The Sperling Neurosurgery Group offers MRI-guided Focused Ultrasound for the treatment of drug resistant tremors (or for patients who don’t want to take prescription medications). This noninvasive approach to treating hand tremors is an outpatient procedure that directs “beams” of ultrasound into the brain to deaden the small area that transmits dysfunctional movement signals to the hands. The result is durable tremor control, and regaining excellent quality of life.

Visit our website for more information on the treatment, and how to contact us.

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¹http://www.dailymail.co.uk/health/article-2081481/How-alcohol-helps-EASE-shakes.html
²http://www.drugfreeworld.org/drugfacts/alcohol/a-short-history.html
³https://greatist.com/health/alcoholic-drinks-benefits
⁴Louis E, Michalec M. Semi-quantitative Data on Ethanol Consumption in 354 ET Cases and 370 Controls. J Neurol Sci. 2014 Dec 15; 347(0): 174–178.
⁵Ibid.