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Therapy for Tourette syndrome∗
Published in Carlotta Zanaboni Dina, Mauro Porta, James F. Leckman, Understanding Tourette Syndrome, 2019
Carlotta Zanaboni Dina, Mauro Porta
Other treatments in TS are: in cases of TS related to streptococcal or viral infection: plasmapheresis and intravenous immunoglobulin (medical procedure, which consists in the exchange of blood plasma), prednisolone (steroid), acyclovir (antiviral agent), ceftriaxone (antibiotic).clomifene, flutamide and finasteride (hormonal therapies).new pharmacological agents in clinical research such as deutetrabenazine (monoamine depletor), which has been studied in the last two years with promising efficacy.transcranial magnetic stimulation, i.e. electromagnetic induction causing an electric current flux in a target brain region of the TS patient.laser therapy, i.e. infrared laser blood irradiation treating the antioxidative system of TS.
VMAT2 Inhibitors for the Treatment of Tardive Dyskinesia
Published in Issues in Mental Health Nursing, 2022
Barbara Warren, Dawn Vanderhoef, Jessica Johnson
Deutetrabenazine, a deuterated molecular form of tetrabenazine, is approved for both chorea in Huntington’s disease and TD (Austedo [Prescribing Information], 2020). Incorporating deuterium in place of specific hydrogen atoms is thought to slow metabolism and prolong half-life compared to tetrabenazine allowing for twice-daily administration with food (Schneider et al., 2020). The pharmacologic activity of deutetrabenazine is thought to be similar to tetrabenazine, in that it is mediated by a blend of four isomeric dihydrotetrabenazine metabolites ([+]-alpha, [−]-alpha, [+]-beta, and [−]-beta) that inhibit VMAT2 and have varying affinities for off-target receptors, including dopamine D1 and D2 receptors and serotonin 5-HT1A, 5-HT2A, and 5-HT7 receptors (Grigoriadis et al., 2017; Stahl, 2018). While circulating levels of the four individual isomers of deutetrabenazine have not been published to date, it is likely that they are similar to those of tetrabenazine, with the most selective and potent isomer ([+]-alpha) present at low levels in plasma (Grigoriadis et al., 2017; Skor et al., 2017; Stahl, 2018).
Deutetrabenazine for tardive dyskinesia and chorea associated with Huntington’s disease: a review of clinical trial data
Published in Expert Opinion on Pharmacotherapy, 2019
Daniel O. Claassen, Michael Philbin, Benjamin Carroll
For patients with TD, treatment with deutetrabenazine led to significant reductions of TD-related involuntary movements. Specifically, the reductions in AIMS and CGIC scores observed in the AIM-TD study in patients receiving deutetrabenazine for the treatment of TD are promising results, as improvements may reduce social stigma, a common problem for this patient population [2,54,55]. However, the outcomes of the ARM-TD study did not fully reflect the results seen in the AIM-TD study, as CGIC and PGIC scores for patients with TD did not improve significantly over scores in the placebo group. This discrepancy may be a result of the difficult evaluation process of TD-related motor function due to its dynamic nature and the variable symptom appreciation by clinicians and patients. Furthermore, psychiatrists, who mostly evaluated the patients in the ARM-TD study, may not have sufficient training on the scales used in the study.
Deutetrabenazine for the treatment of Huntington’s chorea
Published in Expert Review of Neurotherapeutics, 2018
Hassaan Bashir, Joseph Jankovic
Huntington’s disease is a fatal, neurodegenerative condition for which no disease modifying therapy is available. Chorea is the most common motor manifestation.Tetrabenazine and deutetrabenazine are the only drugs with formal approval for treatment of chorea in Huntington’s disease; deutetrabenazine and valbenazine have been also approved for the treatment of tardive dyskinesia.The pivotal, randomized, placebo-controlled FIRST-HD trial and preliminary updates from its open-label extension, ARC-HD, deliver the supportive evidence for the safety, tolerability, and efficacy of deutetrabenazine in the treatment of HD chorea.No head-to-head studies between tetrabenazine and deutetrabenazine have been performed although efficacy in HD chorea is probably similar.Deutetrabenazine has been shown to have an adverse effect profile similar to placebo although more real-life experience is needed.The role of VMAT2 inhibitors in the treatment of hyperkinetic movement disorders is rapidly expanding.