- Mechanism of Action: unknown. Deutetrabenazine reversibly depletes the levels of monoamines, such as dopamine, serotonin, norepinephrine, and histamine, from nerve terminals via its active metabolites. –DrugBank
- Indications: Deutetrabenazine is used to treat movement disorders, including tardive dyskinesia and chorea caused by Huntington’s disease. Deutetrabenazine works in the central nervous system (CNS) to prevent the absorption of certain chemicals (eg, dopamine, serotonin, norepinephrine, histamine).
- Dosing Forms (see above)/Considerations: Tablet, with food.
Quick Pearls
Usual Adult Dose for Tardive Dyskinesia:
- Initial Dose: 6 mg orally 2 times a day
Maintenance Dose: may increase the dose in increments of 6 mg/day at weekly intervals.
Maximum Dose: 48 mg/day in divided doses
Additional Notes:
- Determine the dose for each patient based on tardive dyskinesia reduction and tolerability.
- Administer total daily dosages of 12 mg or more in 2 divided doses.
- May discontinue this drug without tapering.
- Re-titrate dose when resuming this drug following therapy interruption of greater than 1 week; resume therapy at the previous maintenance dose without titration if treatment interruption is less than 1 week.
- For patients at risk for QT prolongation, assess the QT interval before and after increasing the total dosage above 24 mg per day.
Pros
- a good alternative if the patient had contraindications or couldn’t tolerate valbenazine, benztropine, etc.
- easy dosing, no dose restrictions, no taper
- Approved to treat TD and HD chorea
Cons
- COVERAGE/Costly: usually reps will help but out-of-pocket $4396.66
- Many Side-Effects: plus similar to antipsychotics SE including neuroleptic malignant syndrome, parkinsonism, and heart/QT prolongation/cardiac risks
- TD symptoms may still be present
Comparisons
Additional Information
Official Medication Website: Austedo (Deutetrabenazine)
- Deutetrabenazine for Tardive Dyskinesia -MD Edge
- Drug Information -Mayo Clinic
- Featured Clinical Topic-Psychiatry: New Treatment Options for Tardive Dyskinesia –Missouri Society of Health-System Pharmacists (the graphic below)
Ingrezza vs Austedo
