A 58-year-old man with chronic schizophrenia treated with antipsychotics for 20 years develops persistent involuntary chewing, lip smacking, and choreoathetoid movements of his fingers. The movements diminish during sleep. After stopping the offending drug, which agent is approved for treating this condition?
- A Levodopa-carbidopa
- B Valbenazine ✓
- C Propranolol
- D Pramipexole
Correct answer: B. Valbenazine
Explanation
The presentation is classic tardive dyskinesia. Vesicular monoamine transporter 2 (VMAT2) inhibitors such as valbenazine and deutetrabenazine deplete presynaptic dopamine stores and are the approved specific treatments. Levodopa would aggravate dyskinesia, pramipexole is a dopamine agonist used in Parkinson disease, and propranolol helps akathisia rather than tardive dyskinesia. The improvement during sleep reflects that these are hyperkinetic dopaminergic movements.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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