Tetrabenazine is a drug for the symptomatic treatment of hyperkinetic movement disorders. It is sold under the brand names Nitoman and Xenazine among others. On August 15, 2008, the US Food and Drug Administration (FDA) approved the use of tetrabenazine to treat chorea associated with Huntington's disease. Although other drugs had been used "off-label", tetrabenazine was the first approved treatment for Huntington's disease in the United States. The compound has been known since the 1950s.

Medical uses

Tetrabenazine is used as a treatment, but not as a cure, for hyperkinetic disorders such as:

  • Huntington's disease – specifically, the chorea associated with it
  • Tourette syndrome and other tic disorders
  • Tardive dyskinesia, a serious and sometimes irreversible side effect of long-term use of many antipsychotics, mainly typical antipsychotics
  • Hemiballismus, spontaneous flinging limb movements due to contra-lateral subthalamic nucleus damage

Tetrabenazine has been used as an antipsychotic in the treatment of schizophrenia, both in the past and in modern times.

Adverse effects

The most common adverse effects, which have occurred in at least 10% of subjects in studies and at least 5% greater than in subjects who received placebo, have been: sedation or somnolence, fatigue, insomnia, depression, suicidal thoughts, akathisia, anxiety, and nausea. The drug results in selective depletion of dopamine at low doses of 0.25 to 1.0mg/kg and induces a low-effort bias in effort-based decision-making tasks at these doses. In contrast, levels of serotonin and norepinephrine are only reduced by up to 15 to 30% at this dosage. Selegiline shows a complicated U-shaped dose–response curve in its efficacy in the model.

See also

  • Deutetrabenazine

References

  • Xenazine prescribing information FDA
  • NIMH Repository data sheet
  • "Tetrabenazine" from HOPES: Huntington's Disease Outreach Project for Education at Stanford
  • Detailed monograph on tetrabenazine on rxmed.com
  • Information on tetrabenazine from netdoctor.co.uk