Valbenazine for the treatment of tardive dyskinesia

ABSTRACT

Introduction: Tardive dyskinesia (TD) is a hyperkinetic movement disorder that may result from treatment with antipsychotics or other dopamine receptor blocking agents. Underlying pathophysiology is incompletely understood but since the 1970s dopamine depleting agents have been used to reduce involuntary movements. The search for safe, effective treatments for TD is ongoing. Valbenazine, a novel VMAT2 inhibitor, has recently been FDA approved for treatment of TD.

Areas covered: An overview of TD, unmet medical needs and current treatment guidelines are presented. The background, chemistry and clinical development of valbenazine to treat TD is detailed. A competitive market is developing as the treatment gap is identified and potential therapies are discussed in context of a broader market overview.

Expert opinion: Antipsychotic use is growing among adults and children in the U.S. Consequently, prevalence of TD is expected to rise. Cessation of antipsychotics is often not possible as the psychiatric condition may deteriorate. Increasing doses of an antipsychotic to suppress involuntary movements is not sustainable long term as underlying TD worsens and movements typically recur. There were no FDA approved treatments for TD. The approval of valbenazine to treat TD is a critical step in addressing this gap in neurologic care.

KEYWORDS:

• Adverse effects
• antipsychotics
• dopamine depletor
• dopamine receptor blocking agents
• extrapyramidal symptoms
• involuntary movements
• tardive dyskinesia
• neuroleptics
• valbenazine
• vmat2 inhibitor

Declaration of interest

LC Seeberger reports consulting fees for advisory board from Adamas and Auspex. R A Hauser reports consulting fees from Guidepoint Global, Gerson Lehrman Group, LCN Consulting, Putnam Associates, National Parkinson Foundation, eResearch Technology, Inc., Lundbeck LLC, Cynapsus Therapeutics, Sarepta Therapeutics, Adamas Pharmaceuticals, Neurocrine Biosciences, Back Bay Life Science, Teva Pharmaceuticals, US WorldMeds, Biotie Therapies, Michael J. Fox Foundation, Neuropore Therapies, National Institutes of Health, Projects in Knowledge, Prexton Therapeutics, Acorda Therapeutics, Vista Research, LifeMax, Peerview Press, ClinicalMind Medical and Therapeutic Communications, Sunovion Pharmaceuticals, Inc., Academy for Continued Healthcare Learning, Outcomes Insights, Expert Connect, HealthLogix, Cowen and Company, Pharma Two B, Ltd, Pfizer, Inc., RMEI Medical Education for Better Outcomes. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.