195 Current Use and Trends in the Management of Tardive Dyskinesia: Role of VMAT2 Inhibitors

Abstract

Objectives

Tardive Dyskinesia (TD) is a debilitating condition that requires prompt care and intervention. Studies demonstrated the probable role of Vesicular Monoamine Transport 2 (VMAT2) in the pathogenesis of TD and use of VMAT2inhibitors in managing TD. Our aim is to provide available data on the management of TD and to determine the efficacy ofvarious VMAT2 inhibitors for independent use. Also, to identify their use in combination and assess if there, any change inoutcome with early intervention.

Methods

We did a pivotal search of the scientific literature by querying PubMed and Google Scholar for studies on treatment modalities of TD including atypical antipsychotics and VMAT2 inhibitors. Also, references from publications were accessed for review.

Results

Early detection and prevention are of paramount importance in managing TD. Cessate the antipsychotic been using andother dopamine blocking agents that probably implicated in causing the symptoms. Certain studies showed the use of new atypical antipsychotics like Paliperidone, Quetiapine in small titrated dose resolving the symptoms. According to the available data, using benzodiazepines, botulinum toxin injections and VMAT2 inhibitors like Valbenazine, Tetrabenazine, andDeutetrabenazine also managed TD with efficacy. Valbenazine has breakthrough global approval in resolving the symptoms. Although other VMAT2 inhibitors were used for TD earlier and showed to be effective in managing TD, larger trials are required showing their safety and reliability in efficacy.

Conclusions

VMAT2 inhibitors were tested as efficacious in managing TD. Valbenazine and recently deutetrabenazine has been approved by US Food and Drug Administration (FDA) to treat TD. However, Tetrabenazine is yet to be approved by FDA. More clinical trials are required exploring their efficacy by comparing them or using them in combination. Our review also suggests timely detection and earlier intervening, especially if witnessed in children and adolescents would differ the outcome of TD.

Funding Acknowledgements

No funding.