Psychiatry · Schizophrenia and Other Psychotic Disorders

Tardive dyskinesia (TD) resulting from long-term antipsychotic use is best treated with which agent that has FDA approval specifically for TD?

  • A Propranolol
  • B Clonazepam
  • C Valbenazine
  • D Vitamin E
Correct answer: C. Valbenazine

Explanation

Valbenazine (Ingrezza) and deutetrabenazine (Austedo) are vesicular monoamine transporter 2 (VMAT2) inhibitors that received FDA approval for the treatment of tardive dyskinesia. They deplete presynaptic dopamine by preventing vesicular storage, reducing excessive dopaminergic tone in the nigrostriatal pathway that underlies TD involuntary movements. Valbenazine is dosed once daily and is the preferred first-line pharmacological treatment for TD. Propranolol, clonazepam, and Vitamin E have been used historically but lack the level of evidence or regulatory approval of VMAT2 inhibitors for TD.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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