According to the International Essential Tremor Foundation, drinking alcohol as a way to self-medicate essential tremor (ET) gets mixed reviews: “Adults with ET often notice that responsibly drinking alcohol – having one or two drinks before social events for example – reduces tremor for one to two hours. One must consider, though, that a more severe rebound tremor can occur after the effects of alcohol have worn off, especially with excessive alcohol use.”i When it comes to “excessive use” (3-4 or more drinks per day) studies have shown that such heavy drinkers have twice the risk of developing ET in old age.
However, a different form of alcohol has gained the attention of doctors and patients in the ET community. It is called 1-octanol or Octan-1. It is a type of compound called a fatty acid. It has various commercial uses, including a synthesizing agent for ingredients in perfumes and artificial flavors. When consumed, 1-octanol produces a fatty acid in the body called octanic acid (OA). OA is thought to be the agent that lessens ET, without the damaging effects of alcohol. Drinking alcohol for the purpose of controlling ET is discouraged “due to the risks associated with intoxication and the potential medical, social, and legal consequences of chronic alcohol use.”ii
Recent studies suggest that OA may be a safer and more effective alternative to ethanol (the kind of alcohol found in alcoholic beverages). In one 2016 report, 15 adults were given OA at various dose levels from 8-128 mg per kg of body weight. All doses were tolerated with minimum side effects, mostly abdominal discomfort which tended to occur at higher dose levels.iii The team of investigators hypothesize that since OA was given orally in the form of capsules, which had to be swallowed within a minute, the higher number of capsules for the high doses may have contributed to the feeling of discomfort.
The team observed that the greater the dose, the longer the duration of effect in reducing ET in all subjects. Some subjects experienced tremor reduction as long as 5+ hours, with the effect gradually wearing off. It should be noted that the effective dose level is lower than that amount of ethanol people drink to obtain similar tremor control, yet OA appears to be longer-lasting. According to one news report, “In one study in Minneapolis, researchers gave patients a single dose of one milligram of octanol for each kilogram of their weight, and found it significantly decreased tremor for up to 90 minutes.”iv No one has yet determined if there is an optimum dose (scaled to body weight) but the relatively low doses of OA vs. ethanol promise to be safe with at least comparable ET control. Until OA is determined to be approved for wide use, the Sperling Prostate Center cautions those with ET who do find some relief from beer, wine or liquor to drink moderately and responsibly – and always check with your doctor first.
Aside from alcohol/OA intake, pharmaceuticals (beta blockers and anticonvulsants) are the most commonly prescribed ET drugs. However, fewer than 50% of those who suffer from ET obtain the desired relief from such medications, or do not like their side effects. The Sperling Medical Group is pleased to offer MRgFUS to treat ET that does not respond to medication. Our Center uses the FDA-approved device under the image guidance of our state-of-the-art 3T magnet. For more information, contact the Sperling Medical Group.
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i http://www.essentialtremor.org/treatments/medication/
ii Voller B, Lines E, McCrossin G, Tinaz S et al. Dose-escalation study of octanic acid in patients with essential tremor. J Clin Invest. 2016 Apr 1;126(4):1451-7.
iii Ibid.
iv Dobson, R. “How alcohol helps EASE the shakes.” Jan. 2, 2012. http://www.dailymail.co.uk/health/article-2081481/How-alcohol-helps-EASE-shakes.html
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.