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Medical Science Monitor Basic Research


Successful Treatment of Severe Tardive Dyskinesia with Valbenazine, Including a Patient’s Perspective

Unusual clinical course, Challenging differential diagnosis

Richard C. Josiassen, Dawn M. Filmyer, Jack Gillean, Syed Sikandar Shah, Tyler E. Dietterich, Rita A. Shaughnessy

USA Translational Neuroscience LCC, Conshohocken, PA, USA

Am J Case Rep 2017; 18:1185-1189

DOI: 10.12659/AJCR.906454

Available online: 2017-11-08

Published: 2017-11-08


BACKGROUND: Tardive dyskinesia (TD) is a chronic involuntary movement disorder frequently induced by dopamine receptor blockers, particularly first-generation antipsychotics. Until recently, management of TD was restricted to lowering the dose of the current medication, switching to another medication, or using off-label treatments with insufficient evidence of efficacy. Valbenazine, a vesicular monoamine transporter-2 (VMAT2) inhibitor, became the first drug to be approved by the FDA specifically for the treatment of TD.
CASE REPORT: We describe the case of a 49-year-old African-American woman who was diagnosed with bipolar disorder at the age of 34 and treated with lithium carbonate (900 mg daily) and citalopram (10 mg daily). She also received low doses of second-generation antipsychotics for weeks at a time, but these were always discontinued due to severe sedation. Over a decade later, at the age of 45, she experienced rapid onset of severe TD symptoms. She enrolled in a phase III double-blind clinical trial and received valbenazine 80 mg, with encouraging results.
CONCLUSIONS: Once-daily dosing of valbenazine (80 mg) was effective and safe over a long period, even in this atypical case of severe and rapid-onset TD.

Keywords: Movement Disorders, Vesicular Monoamine Transport Proteins