### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi...I am female, age 84yrs.  I had been on metoprolol , but due to a worsening voice tremor consulted with a neurologist for help in this regard...I was prescribed propranolol in 3 graduated doses, and to be adding primadone....however the propranolol side effects did not allow me to the third level. ...confusion and balance problems....I have mistrial valve leak, and a fib...is the primadone a difficult drug to adjust to...also my druggist informs me that the effects of the propranolol will be diminished if taken in conjunction with primadone...I do consult with my neurologist late September, ?  I do want to get some help for my voice tremor...it is devastating  and debilitating to say the least, but I must not jeopardize my heart condition......and a further problem. ..Several food allergies which includes sugar, all dairy products.....the sugar definitely triggers A fibs once my toleration level has been crossed. What a mess eh!!!  I keep active,  gardening, ....also worked to age 75yrs..courtroom clerk....still drive..including recent 300 km. trip....  Thank you for listening......tee....

### output:

Hello. Primadona and Propranolol are widely used in the treatment of essential tremor. By propranolol side effects would be indicated prescribe prima donna associated with propranolol or replace propranolol by prima donna. Primadona has its side effects but in appropriate dose is effective in the treatment of essential tremor. However, your neurologist, at your next visit, will decide on the most appropriate pharmacological treatment for you. I wish you good health.(If the answer has helped you, please indicate this)