Treatment of Tardive Dyskinesia: A General Overview with Focus on the Vesicular Monoamine Transporter 2 Inhibitors

Drugs
Nicki Niemann, J Jankovic

Abstract

Tardive dyskinesia (TD) encompasses the spectrum of iatrogenic hyperkinetic movement disorders following exposure to dopamine receptor-blocking agents (DRBAs). Despite the advent of atypical or second- and third-generation antipsychotics with a presumably lower risk of complications, TD remains a persistent and challenging problem. Prevention is the first step in mitigating the risk of TD, but early recognition, gradual withdrawal of offending medications, and appropriate treatment are also critical. As TD is often a persistent and troublesome disorder, specific antidyskinetic therapies are often needed for symptomatic relief. The vesicular monoamine transporter 2 (VMAT2) inhibitors, which include tetrabenazine, deutetrabenazine, and valbenazine, are considered the treatment of choice for most patients with TD. Deutetrabenazine-a deuterated version of tetrabenazine-and valbenazine, the purified parent product of one of the main tetrabenazine metabolites, are novel VMAT2 inhibitors and the only drugs to receive approval from the US FDA for the treatment of TD. VMAT2 inhibitors deplete presynaptic dopamine and reduce involuntary movements in many hyperkinetic movement disorders, particularly TD, Huntington disease, and Tourette s...Continue Reading

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Citations

Jul 12, 2018·Expert Review of Neurotherapeutics·Hassaan Bashir, Joseph Jankovic
Feb 1, 2019·Neurodegenerative Disease Management·Nicki Niemann, Joohi Jimenez-Shahed
Feb 7, 2019·Neurodegenerative Disease Management·Natalie Witek, Cynthia Comella
Mar 15, 2019·Clinical Neuropharmacology·Nicki Niemann, Joseph Jankovic
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Oct 31, 2019·Expert Opinion on Pharmacotherapy·Laszlo SzpisjakLaszlo Vecsei
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Apr 14, 2020·Neurologic Clinics·Hassaan H Bashir, Joseph Jankovic
Mar 7, 2021·Toxins·Mariam HullJoseph Jankovic
Jul 11, 2021·Bioorganic & Medicinal Chemistry Letters·Shaoyi Sun, Steven S Wesolowski
Apr 3, 2019·Journal of Medicinal Chemistry·Andrew C FlickChristopher J O'Donnell

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