Valbenazine

Introduction: What is Valbenazine?

Valbenazine is a prescription medication primarily used to treat tardive dyskinesia, a condition characterized by involuntary, repetitive body movements often caused by long-term use of antipsychotic medications. Approved by the FDA in 2017, Valbenazine is designed to help manage these symptoms, improving the quality of life for individuals affected by this disorder.

Uses of Valbenazine

Valbenazine is specifically indicated for the treatment of tardive dyskinesia in adults. Tardive dyskinesia can manifest as facial grimacing, tongue movements, and other involuntary muscle contractions, which can be distressing and socially isolating. By targeting the underlying mechanisms of this condition, Valbenazine helps reduce the severity and frequency of these movements.

How Does It Work?

Valbenazine works by inhibiting the vesicular monoamine transporter 2 (VMAT2), a protein responsible for transporting neurotransmitters like dopamine into vesicles in the brain. By blocking VMAT2, Valbenazine decreases the release of dopamine, which is often implicated in the development of tardive dyskinesia. In simpler terms, it helps to balance the levels of dopamine in the brain, reducing the involuntary movements associated with the condition.

Dosage and Administration

The standard dosage of Valbenazine for adults is typically 40 mg or 80 mg capsules taken once daily. Depending on the patient's response and tolerability, the dose may be increased to a maximum of 80 mg per day. Valbenazine is available in capsule form and should be taken orally, with or without food. It is important to follow the prescribing physician's instructions regarding dosage and administration.

Side Effects of Valbenazine

Like all medications, Valbenazine can cause side effects. Common side effects include:

• Drowsiness
• Fatigue
• Dry mouth
• Constipation
• Balance problems or somnolence-related issues (e.g., falls)

Serious side effects may include:

• Depression, suicidal thoughts, or behaviors (monitor closely)
• Suicidal thoughts or behaviors
• Allergic reactions (rash, itching, swelling or angioedema)
• Neuroleptic Malignant Syndrome (NMS; rare, due to VMAT2 inhibition)

Patients should report any unusual or severe side effects to their healthcare provider immediately.

Drug Interactions

Valbenazine may interact with several medications, which can affect its efficacy or increase the risk of side effects. Major drug interactions include:

• Strong CYP3A4 inhibitors (e.g., ketoconazole; reduces valbenazine dose)
• Strong CYP3A4 inducers (e.g., rifampin; may decrease efficacy)
• Monoamine oxidase inhibitors (MAOIs) (contraindicated within 14 days)
• Deuterbenazine or tetrabenazine (avoid concurrent use)

It is crucial for patients to inform their healthcare provider about all medications, supplements, and herbal products they are taking to avoid potential interactions.

Benefits of Valbenazine

The primary benefit of Valbenazine is its ability to significantly reduce the symptoms of tardive dyskinesia, leading to improved daily functioning and quality of life. Unlike some other treatments, Valbenazine is specifically designed for this condition, making it a targeted therapy. Additionally, it has a favorable safety profile compared to older treatments, with fewer side effects related to sedation and cognitive impairment.

Contraindications of Valbenazine

Valbenazine should be avoided in certain populations, including:

• Individuals with a known hypersensitivity to Valbenazine or any of its components.
• Patients with severe hepatic impairment (avoid; no recommendation for moderate).
• Pregnant women should use valbenazine only if the potential benefits outweigh the risks, with a pregnancy registry available for monitoring; breastfeeding women should avoid it or pump and discard milk.

Precautions and Warnings

Before starting Valbenazine, patients should undergo a thorough evaluation, including a review of their medical history and any current medications. Special precautions should be taken for individuals with a history of depression or suicidal thoughts, as Valbenazine may exacerbate these conditions. VMAT2 inhibitors carry a Boxed Warning for depression/suicidality in some patients. Regular follow-up appointments are recommended to monitor the patient's response to treatment and adjust the dosage if necessary.

FAQs

1. What is Valbenazine used for? Valbenazine is used to treat tardive dyskinesia, a condition causing involuntary movements often due to antipsychotic medications.
2. How should I take Valbenazine? Take Valbenazine orally, with or without food, as prescribed by your doctor.
3. What are the common side effects? Common side effects include drowsiness, fatigue, dry mouth, constipation, and weight gain.
4. Can I take Valbenazine with other medications? Inform your doctor about all medications you are taking, as Valbenazine can interact with certain drugs.
5. What should I do if I miss a dose? If you miss a dose, take it as soon as you remember. If it's close to the next dose, skip the missed dose and continue your regular schedule.
6. Is Valbenazine safe during pregnancy? Consult with your healthcare provider if you are pregnant or planning to become pregnant, as the effects are not fully known. Animal data suggest developmental risk.
7. How long does it take for Valbenazine to work? Improvements often seen in 4-6 weeks; full effect up to 12 weeks (per trials).
8. Can Valbenazine cause weight gain? Yes, weight gain is a possible side effect, so monitor your weight and discuss any concerns with your doctor.
9. What should I do if I experience severe side effects? Contact your healthcare provider immediately if you experience severe side effects, such as mood changes or allergic reactions.
10. Is Valbenazine addictive? Valbenazine is not considered addictive, but always use it as prescribed by your healthcare provider.

Brand Names

Valbenazine is marketed under the brand name Ingrezza. It is available in capsule form, making it easy for patients to incorporate into their daily routine.

Conclusion

Valbenazine represents a significant advancement in the treatment of tardive dyskinesia, offering targeted relief from involuntary movements associated with this challenging condition. With its favorable safety profile and specific indications, Valbenazine can greatly enhance the quality of life for those affected. As with any medication, it is essential to consult with a healthcare provider to determine the best treatment plan tailored to individual needs.