The Effects of Valbenazine in Participants with Tardive Dyskinesia

Factor, Stewart A.; Remington, Gary; Comella, Cynthia L.; Correll, Christoph U.; Burke, Joshua; Jimenez, Roland; Liang, Grace; O’Brien, Christopher F.

doi:10.4088/jcp.17m11777

Cited by 72 publications

(55 citation statements)

References 9 publications

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“…Valbenazine has shown to improve TD in the KINECT 3 trial [46]. In this study parkinsonism was an exclusion criteria, and results disclosed no differences between treatment groups both after 6 weeks and after a 1-year period in parkinsonism as assessed by the Simpson-Angus-Scale [47]. With a similar mechanism of action, deutetrabenazine has showed in 2 studies, one in a population with chorea associated with Huntington's Disease and other in patients suffering TD similar DIP rates in both treatment and placebo arms.…”

Section: Pathophysiology and Causal Agentsmentioning

confidence: 61%

See 1 more Smart Citation

Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly

Estévez-Fraga¹,

Zeun²,

Moreno

2018

Drugs Aging

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Drug induced parkinsonism and tardive dyskinesia are iatrogenic consequences of the use of antidopaminergic drugs. Both entities share risk factors, physiopathological mechanisms and to some degree, therapeutic approaches. Here we review both entities and discuss emerging therapies including the recently approved drug deutetrabenazine and relevant aspects for clinical practice such as new diagnostic techniques. Key points:-Drug induced parkinsonism and tardive dyskinesia are iatrogenic consequences of the use of antidopaminergic drugs.-DIP is considered a direct consequence of the blockage of D2 receptors while TD has a more complex physiopathology, including enhanced sensitivity of dopamine receptors.-Both entities are more frequent in older people due to a progressive loss of dopaminergic neurons with age.-New therapies are available for TD, including deutetrabenazine. Compliance with ethical Standards:Disclosure of potential conflicts of interest: no funding was received for this study.The risks of drug-induced parkinsonism/tardive dyskinesia in the elderly and current methods to overcome it. 1.-IntroductionTardive dyskinesia (TD) and drug-induced parkinsonism (DIP) are iatrogenic disorders caused by dopamine receptor blockers (DRB) [1]. They were recognized early after the introduction of antipsychotics[2] to the clinical practice, leading to the finding that DIP caused by reserpine, a dopamine depleter, was related to dopamine deficiency [3].Elderly patients are more susceptible to these side effects, probably due to an age-related decrease in nigral neurons and dopamine [4]. Since the introduction of newer second generation antipsychotics (SGA) the frequency and intensity of these side effects has improved [5] , [6] , [7] , [8] but there is still room for concern [9], [10].TD and DIP share risk factors, pathological mechanisms and management, and might coexist in one given subject. Latest available evidence has clarified some intriguing features of TD and DIP. Meanwhile, new medications to treat TD are now available, highlighting the importance of a thorough, updated, knowledge of this pathologies.This article offers a comprehensive review of the incidence, clinical features and mechanisms behind DIP and TD. The benefits and risks of previous available drugs and those that have been recently approved by regulatory agencies are discussed. Drug induced Parkinsonism DefinitionDIP occurs when symptoms emerge after exposure to drugs, usually those that either deplete dopamine storages [11] or block dopamine receptors [12]. By definition, symptoms should be reversible, six months after the offending agent has been withdrawn[13] but actually up to 20% of patients develop persistent deficits despite drug discontinuation [14] leading to the hypothesis that these patients might have subclinical Parkinson's Disease (PD) unmasked by neuroleptic exposure (umPD), complicating the differential diagnosis [15], especially between aged patients, who are more prone to both PD and DIP. Epidemiology and risk factorsAfter PD, DI...

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Section: Pathophysiology and Causal Agentsmentioning

confidence: 61%

“…Following this results FDA-approval took place during the same year [128]. The 1-year follow-up study showed no risk of suicidal ideation worsening akathisia or parkinsonism [47].…”

Section: Prevention and Treatment (Figure 2)mentioning

confidence: 89%

Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly

Estévez-Fraga¹,

Zeun²,

Moreno

2018

Drugs Aging

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“…A long-term study (KINECT 3 Extension) reinforced these outstanding results about efficacy, safety and tolerability [16]. The most common adverse events were headache, urinary tract infection, diarrhea, dizziness, suicidal ideation and depression [16]. Moreover, a further analysis of these studies confirmed the statistically significant improvements in TD severity both overall and in separate body regions [17].…”

Section: Valbenazinementioning

confidence: 83%

“…In addition to efficacy, VBZ showed a favorable side effect profile and it was well tolerated by patients. A long-term study (KINECT 3 Extension) reinforced these outstanding results about efficacy, safety and tolerability [16]. The most common adverse events were headache, urinary tract infection, diarrhea, dizziness, suicidal ideation and depression [16].…”

Section: Valbenazinementioning

confidence: 93%

Selecting dopamine depleters for hyperkinetic movement disorders: how do we choose?

Szpisjak

Salamon

Zádori

et al. 2019

Expert Opinion on Pharmacotherapy

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“…Die Verwendung des GABA-A-Agonisten Clonazepam in der Therapie der TD wurde in den 1970er-und 1980er-Jahren untersucht, was schließlich in der Publikation einer sehr kleinen RCT im Jahr 1990 resultierte. [53,56,57,58]. Für Deutetrabenazin existieren zwei hochwertige RCT über 12 Wochen, die deutliche Effekte gemessen am AIMS zeigen konnten.…”

Section: Risikofaktoren Und Präventionunclassified

Prävention und Behandlung von Antipsychotika-induzierten tardiven Dyskinesien

Erbe¹

2018

Fortschr Neurol Psychiatr

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Tardive dyskinesias (TDs) are still common long-term sequelae of antipsychotic treatment. They are generally irreversible and associated with cognitive deficits, a decrease in quality of life and increased mortality. Furthermore, they potentially contribute to further stigmatization of the affected patients. However due to limited treatment options, antipsychotic drugs are still one of the cornerstones in treatment of most severe mental illnesses. Therefore, knowledge about risk factors and prevention of TDs is crucial. If TDs occur, the immediate optimization of the antipsychotic drug regimen is required. Targeted medical treatments such as VMAT - 2 inhibitors can be considered. The novel VMAT-2 inhibitors are not yet approved in Germany. Other drugs that are currently used to treat TDs include clonazepam and gingko biloba. This review summarizes the current evidence of treatment options of TDs and seeks to formulate clinical recommendations for the prevention and management of TDs.

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The Effects of Valbenazine in Participants with Tardive Dyskinesia

Abstract: Background: Valbenazine, a highly selective vesicular

Cited by 72 publications

References 9 publications

Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly

Current Methods for the Treatment and Prevention of Drug-Induced Parkinsonism and Tardive Dyskinesia in the Elderly

Selecting dopamine depleters for hyperkinetic movement disorders: how do we choose?

Prävention und Behandlung von Antipsychotika-induzierten tardiven Dyskinesien

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