VMAT2 Inhibitors: New Drugs for the Treatment of Tardive Dyskinesia

Consult Pharm. 2018 Apr 1;33(4):201-209. doi: 10.4140/TCP.n.2018.201.

Abstract

Objective: To provide a review of tardive dyskinesia (TD) symptoms, etiology, pathophysiology, and treatments.

Data sources: PubMed, Web of Science, ClinicalTrials. gov, and Google Scholar were searched for relevant literature using a combination of the following terms: tardive dyskinesia, treatment, management, guidelines, tetrabenazine, deutetrabenazine, and valbenazine. Sources were limited to human data.

Study selection/data extraction: Articles were reviewed for relevance to TD therapy. Reference lists were manually searched for other relevant articles. Selected literature was published between 1968 and 2017.

Data synthesis: This article reviews treatment options available for patients with TD. Many agents have been tried off-label to manage symptoms, with limited evidence of benefit. The Food and Drug Administration approved the first drug to treat TD valbenazine on April 11, 2017.

Conclusion: TD is largely iatrogenic. Valbenazine's approval by the Food and Drug Administration was followed by the approval of deutetrabenazine, a drug with similar mechanism of action. Further data from postmarketing studies will be needed to verify that valbenazine's adverse effect profile is different from the profiles of tetrabenazine and deutetrabenazine.

Publication types

  • Review

MeSH terms

  • Drug Approval*
  • Humans
  • Practice Guidelines as Topic
  • Tardive Dyskinesia / drug therapy*
  • Tardive Dyskinesia / physiopathology
  • Tetrabenazine / adverse effects
  • Tetrabenazine / analogs & derivatives
  • Tetrabenazine / pharmacology
  • Tetrabenazine / therapeutic use
  • United States
  • United States Food and Drug Administration
  • Valine / adverse effects
  • Valine / analogs & derivatives
  • Valine / pharmacology
  • Valine / therapeutic use
  • Vesicular Monoamine Transport Proteins / antagonists & inhibitors*

Substances

  • SLC18A2 protein, human
  • Vesicular Monoamine Transport Proteins
  • valbenazine
  • Valine
  • deutetrabenazine
  • Tetrabenazine