HelixTalk Episode #76 - The New Move: Treating Tardive Dyskinesia

Date posted: April 3, 2018, 6:00 am

In this episode, we discuss two new agents (valbenazine and deutetrabenazine) -- the first of their kind to receive FDA approval to manage tardive dyskinesia most commonly associated with antipsychotic use.

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Key Concepts

1. Tardive dyskinesia is a fairly common consequence of long term antipsychotic use, though other medications outside the realm of psychiatry may contribute.
2. Up to this point, management of tardive dyskinesia was largely relegated to removal of the offending agent as data supporting pharmacologic treatment was minimal.
3. Two new agents, valbenazine and deutetrabenazine, are now available and carry FDA approval for management of symptoms. However these agents are costly, lack robust clinical response, and theoretically may contribute to some fairly serious risk of side effects.  Further data may be necessary to solidify their place in therapy regarding long term use.
4. In the meantime, minimizing of symptoms of tardive dyskinesia by realizing and modifying risk factors is essential.

References

1. Anderson KE, Stamler D, Davis MD, et al. Deutetrabenazine for treatment of involuntary movements in patients with tardive dyskinesia (AIM-TD): a double-blind, randomized, placebo-controlled, phase 3 trial. The Lancet Psychiatry. 2017;4(8):595-604.
2. Hauser RA, Factor SA, Marder SR, et al. KINECT 3: a phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. American Journal of Psychiatry. 2017;174(5):476-84.