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Tardive Dyskinesia (TD)
Published in Charles Theisler, Adjuvant Medical Care, 2023
TD can be associated with significant and often irreversible functional impairment, reducing the quality of life and increasing social withdrawal. Major risk factors for TD include older individual and cumulative exposure to dopamine receptor blocking agents. There are two FDA-approved prescription treatments for TD: valbenazine and deutetrabenazine.
The incidence and economic burden of extrapyramidal symptoms in patients with schizophrenia treated with second generation antipsychotics in a Medicaid population
Published in Journal of Medical Economics, 2022
Aditi Kadakia, Brenna L. Brady, Carole Dembek, G. Rhys Williams, Justine M. Kent
Antipsychotic medications are the mainstay for acute and chronic pharmacologic treatment of patients with schizophrenia6,7. Antipsychotics are mainly dopamine D2 and serotonin 5-HT2A antagonists and are associated with varying levels of side-effects, often relating to their D2 antagonistic effect, such as extrapyramidal symptoms (EPS) including acute dystonia, akathisia, and parkinsonism6,8. Medications such as benztropine, trihexyphenidyl, amantadine, and biperiden have been used to treat EPS6. While not common, following sustained exposure to antipsychotic medications, the abnormal involuntary movement disorders can become persistent, a condition called tardive dyskinesia6. Medications such as deutetrabenazine, valbenazine, and tetrabenazine are used to treat tardive dyskinesia6.
VMAT2 Inhibitors for the Treatment of Tardive Dyskinesia
Published in Issues in Mental Health Nursing, 2022
Barbara Warren, Dawn Vanderhoef, Jessica Johnson
Given their crucial role in optimizing psychiatric patient care, it is important for nursing professionals to stay up to date with available online resources and educational programming on TD, such as www.medscape.com/mtv/tardive-dyskinesia-s01/ and www.psychcongress.com/psych-topics/tardive-dyskinesia. Psychiatric nurses are uniquely positioned to educate patients and caregivers on the risks of antipsychotic-induced movement disorders and the need to talk with their doctor and/or nurse about any concerns or issues with abnormal movements. Once TD has been diagnosed, nurses can reassure patients that FDA-approved treatments for TD are now available. Valbenazine and deutetrabenazine have been studied in clinical trials and have been shown to be effective and safe to use in conjunction with patients’ current antipsychotic therapies.
State-of-the-art pharmacological approaches to reduce chorea in Huntington’s disease
Published in Expert Opinion on Pharmacotherapy, 2021
Jessie S. Gibson, Daniel O. Claassen
Valbenazine is a VMAT-2 inhibitor which, like deutetrabenazine, is indicated for treatment of tardive dyskinesia [95]. Valbenazine has not yet been approved by the FDA for treatment of HD chorea, but trials are ongoing (NCT04102579). Valbenazine is a prodrug of a major tetrabenazine metabolite and is dosed once a day. Unlike deutetrabenazine and tetrabenazine, doses for valbenazine are more strictly defined (i.e. recommend 80 mg daily vs a dosing range based on patient response). Reported side effects in clinical trials have been similar between valbenazine and deutetrabenazine, with somnolence being the most common adverse reaction [93,95]. If proven to be effective in HD patients, this may represent an additional antichoreatic option for patients who struggle with medication compliance or who have had inadequate responses to existing VMAT-2 inhibitors.