(#52) Evidence-Based Recommendations for Treating Tardive Dyskinesia With a Vesicular Monoamine Transporter 2 (VMAT2) Inhibitor

Abstract: Two vesicular monoamine transporter 2 (VMAT2) inhibitors, valbenazine and deutetrabenazine, are approved for the treatment of tardive dyskinesia (TD). Current treatment guidelines and consensus panels recommend the use of these medications as first line in individuals who have TD, regardless of symptom severity (mild or moderate/severe). The efficacy, safety, and tolerability of VMAT2 inhibitors are well-established in TD, but valbenazine and deutetrabenazine are different drugs. A narrative review of the evidence for both medications is presented. Topics to be covered include the following: pharmacology and pharmacokinetics; available formulations and dosing requirements; potential drug-drug interactions (or lack thereof); and available data in special populations, including adults ≥65 years of age and those with renal or hepatic impairment. Understanding these medications, including their differences, will help clinicians make more informed decisions when discussing TD treatment options with patients.

Short Description: Two vesicular monoamine transporter 2 (VMAT2) inhibitors, valbenazine and deutetrabenazine, are approved for the treatment of tardive dyskinesia (TD). The efficacy, safety, and tolerability of both medications are well established in TD. However, valbenazine and deutetrabenazine are different medications, each with a specific pharmacological profile, available formulations, dosing schedules, and available data in special populations. This narrative review describes their differences, with support from published evidence.

Name of Sponsoring Organization(s): Neurocrine Biosciences, Inc.