{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:01:20Z","timestamp":1790348480345,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The first International Parkinson and Movement Disorder Society Evidence\u2010Based Medicine (MDS\u2010EBM) review for essential tremor (ET) was published in 2019; since then, the modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was adopted by MDS, and new evidence exists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to update EBM conclusions for medical treatments of ET with a focus on longer follow\u2010up periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted for randomized controlled trials (RCTs) investigating medical interventions for ET with a minimum 1\u2010month follow\u2010up, with subsequent appraisal of data using an MDS\u2010EBM framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010one RCTs were included evaluating 16 interventions against placebo. Nine interventions were evaluated by more than one RCT: alprazolam, botulinum toxin type A (BtA), levetiracetam, phenobarbitone, pregabalin, primidone, propranolol, topiramate, and trazodone. The remainder were studied in a single RCT (acetazolamide, flunarizine, gabapentin, mirtazapine, perampanel, progabide, and zonisamide). Trial sample size ranged from 5 to 117 participants, and study duration ranged from 4 to 28\u2009weeks. More than one RCT documented improvement in tremor severity for propranolol, primidone, topiramate, and BtA. Using the modified GRADE framework, we found significant methodological shortcomings in the studies, resulting in insufficient evidence for all interventions. Concerns about risk of bias and imprecision commonly limited the ability to make stronger recommendations for these interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Current evidence from RCTs with at least 1 month of follow\u2010up is insufficient to confidently support the efficacy of available medical treatments for ET. There is a need for longer, higher\u2010quality clinical trials to improve treatment recommendations and guide decision\u2010making for clinicians and patients with ET. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70184","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T12:36:50Z","timestamp":1768912610000},"page":"815-825","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Update on Medical Treatments for Essential Tremor: An International Parkinson and Movement Disorder Society Evidence\u2010Based Medicine Review"],"prefix":"10.1002","volume":"41","author":[{"given":"Deepa","family":"Dash","sequence":"first","affiliation":[{"name":"Department of Clinical Neurological Sciences, Division of Neurology University of Western Ontario  London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences University of Calgary, and Hotchkiss Brain Institute  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Schwingenschuh","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly E.","family":"Lyons","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center, Department of Neurology Parkinson's Disease and Movement Disorder Division  Kansas City KS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng\u2010King","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurology National Neuroscience Institute, Duke NUS Medical School  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia M.","family":"Testa","sequence":"additional","affiliation":[{"name":"Department of Neurology University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago Perez","family":"Lloret","sequence":"additional","affiliation":[{"name":"Observat\u00f3rio de Salud, Vicerrectorado de Investigaci\u00f3n, Pontificia Universidad Cat\u00f3lica Argentina, Consejo Nacional de Investigaciones Cient\u00edficas y T\u00e9cnicas  Buenos Aires Argentina"},{"name":"Departamento de Fisiolog\u00eda Facultad de Medicina, Universidad de Buenos Aires  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Balint","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital and University of Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade de Lisboa, Faculdade de Medicina  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5267-0784","authenticated-orcid":false,"given":"Rob M.A.","family":"de Bie","sequence":"additional","affiliation":[{"name":"Department of Neurology Amsterdam University Medical Center, University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3295-6897","authenticated-orcid":false,"given":"Monty 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