Find cause of tremor and eliminate if it could be contributing to the patient's level of dysfunction or disability. Review the differential diagnosis list found in the Help button in the last question. In some conditions, direct treatment of the tremor with a Beta blocker or benzodiazepine may be helpful, although this should be limited to clear indications since this introduces another drug with the potential for additional side effects.
It may be noted that clinicians have trouble determining the significance of tremors that wax and wane in severity, especially if the variability seems to be in response to stress or anxiety. It seems to be commonly assumed that tremors that worsen under stress should be taken less seriously ("It always gets worse when you are watching him: he's just trying to get attention.") Actually, all tremors regardless of etiology become more severe under the influence of anxiety (e.g. social anxiety) or stress.
Recommendation #155-2
