Tardive dyskinesia (TD) is a late-onset movement disorder from antipsychotics. The FIRST-LINE approved pharmacological treatment for TD is:
- A Tetrabenazine
- B Valbenazine ✓
- C Clonazepam
- D Trihexyphenidyl (benztropine)
Correct answer: B. Valbenazine
Explanation
Valbenazine and deutetrabenazine are the FDA/approved agents specifically for tardive dyskinesia. They act as vesicular monoamine transporter 2 (VMAT2) inhibitors, depleting presynaptic dopamine in the striatum, reducing the dopamine hypersensitivity that underlies TD. Valbenazine has once-daily dosing and a better tolerability profile (less depression) than older tetrabenazine. Anticholinergics (trihexyphenidyl) worsen TD. Benzodiazepines may help short-term but are not approved for TD specifically.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
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