Austedo for Tardive Dyskinesia
What is Austedo?
Austedo (deutetrabenazine) is a medication approved by the FDA for the treatment of tardive dyskinesia (TD), a condition characterized by involuntary movements, often caused by prolonged use of antipsychotic medications. Please read our blog here for more on what tardive dyskinesia is, including a video reference.
Efficacy
Studies have shown that approximately 67% of patients experience at least a 50% improvement in symptoms with Austedo, and about 42% achieve a 70% improvement over a long-term treatment period.
Starting vs. Maintenance Dosing
There is a 4 week titration kit that gets patients to 30 mg doses: Patients typically start Austedo XR 12 mg x1 week, 18mg x1 week, 24mg x1 week. 24 mg is the 1st dose that is considered potentially therapeutic. Since the side effect profile tends to be mild and unrelated to dosing, we continue to increase by 6 mg weekly with a goal dose of 36 mg daily for most patients. For very severe TD, maximum dose is 48 mg daily. Comment end
Potential Side Effects
Common side effects include nasopharyngitis, insomnia, and fatigue. Other potential side effects are depression, suicidal thoughts, QT prolongation, parkinsonism, and neuroleptic malignant syndrome. Patients should not operate heavy machinery until they understand how Austedo affects them.
Potential Contraindications
Austedo is contraindicated in patients with hepatic impairment, those taking monoamine oxidase inhibitors (MAOIs) or reserpine, and patients with untreated or inadequately treated depression.
FDA Approval Information
Austedo was approved by the FDA for the treatment of TD in adults in 2017. It is the first vesicular monoamine transporter 2 (VMAT2) inhibitor approved for this condition.
Off-Label Benefits
Research has indicated potential off-label uses of Austedo for conditions like Huntington's disease-associated chorea, demonstrating its broader efficacy in managing involuntary movement disorders.
References
Long-Term Safety and Efficacy of Deutetrabenazine in Tardive Dyskinesia: Journal of Neurology, Neurosurgery & Psychiatry
Teva’s Real-World Evidence on Austedo: Teva Pharmaceuticals
FDA Approval and Safety Information: FDA
