Abstracts
3427243
(#37) Clinical Guidance for the Use of VMAT2 Inhibitors to Treat Tardive Dyskinesia: Insights From a Multidisciplinary Panel
Abstract: Background: Tardive dyskinesia (TD) is a hyperkinetic movement disorder associated with chronic exposure to dopamine-receptor blocking agents such as antipsychotics. While vesicular monoamine transporter 2 (VMAT2) inhibitors are approved for TD treatment, practical, consensus-based guidance for real-world use remains limited.
Methods: A multidisciplinary advisory panel of psychiatry and movement disorder experts convened to develop consensus recommendations for VMAT2 inhibitor use in clinical practice. Using an iterative discussion process informed by clinical experience and available evidence, the panel met virtually on December 7, 2025, followed by focused small-group sessions (late December 2025 to January 2026) addressing VMAT2 inhibitor selection, treatment expectations, optimization, adverse event considerations, and long-term care. Recommendations were refined during a full panel on February 2, 2026.
Results: The panel recommended a patient-centered approach to VMAT2 inhibitor selection and initiation that emphasizes setting expectations, individualizing titration schedules, and discussing the potential impact on functional outcomes. In case of inadequate response, clinicians should confirm optimal dosing, evaluate adherence and cytochrome P450-related interactions, consider switching agents after a sufficient trial, and, finally, reassess diagnosis. Recommendations also addressed proactive adverse event monitoring and management, the importance of sustained therapy due to symptom recurrence after discontinuation, navigation of access and transitions of care, and individualized strategies for complex presentations, including TD co-occurring with other movement disorders.
Conclusions: These consensus recommendations provide pragmatic, patient-centered guidance to optimize VMAT2 inhibitor use across diverse clinical scenarios in TD.
Short Description: A multidisciplinary consensus panel convened in February 2026 to review clinical experience, emerging evidence, and real-world challenges related to vesicular monoamine transporter 2 inhibitor use for tardive dyskinesia. Through structured discussions, the panel developed pragmatic, patient-centered recommendations addressing treatment selection and initiation, optimization, inadequate response, adverse events, long-term therapy, and complex clinical circumstances.
Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC
Methods: A multidisciplinary advisory panel of psychiatry and movement disorder experts convened to develop consensus recommendations for VMAT2 inhibitor use in clinical practice. Using an iterative discussion process informed by clinical experience and available evidence, the panel met virtually on December 7, 2025, followed by focused small-group sessions (late December 2025 to January 2026) addressing VMAT2 inhibitor selection, treatment expectations, optimization, adverse event considerations, and long-term care. Recommendations were refined during a full panel on February 2, 2026.
Results: The panel recommended a patient-centered approach to VMAT2 inhibitor selection and initiation that emphasizes setting expectations, individualizing titration schedules, and discussing the potential impact on functional outcomes. In case of inadequate response, clinicians should confirm optimal dosing, evaluate adherence and cytochrome P450-related interactions, consider switching agents after a sufficient trial, and, finally, reassess diagnosis. Recommendations also addressed proactive adverse event monitoring and management, the importance of sustained therapy due to symptom recurrence after discontinuation, navigation of access and transitions of care, and individualized strategies for complex presentations, including TD co-occurring with other movement disorders.
Conclusions: These consensus recommendations provide pragmatic, patient-centered guidance to optimize VMAT2 inhibitor use across diverse clinical scenarios in TD.
Short Description: A multidisciplinary consensus panel convened in February 2026 to review clinical experience, emerging evidence, and real-world challenges related to vesicular monoamine transporter 2 inhibitor use for tardive dyskinesia. Through structured discussions, the panel developed pragmatic, patient-centered recommendations addressing treatment selection and initiation, optimization, inadequate response, adverse events, long-term therapy, and complex clinical circumstances.
Name of Sponsoring Organization(s): Teva Branded Pharmaceutical Products R&D LLC
