Tardive Dyskinesia – VMAT2 Inhibitors — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardMovement DisordersTardive Dyskinesia – VMAT2 InhibitorsSCE Neurology

A 45-year-old woman with known tardive dyskinesia from long-term antipsychotic use presents with persistent involuntary orofacial movements despite stopping the causative antipsychotic 6 months ago. What treatment has been approved specifically for tardive dyskinesia?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Valbenazine or deutetrabenazine — VMAT2 (vesicular monoamine transporter 2) inhibitors

Valbenazine and deutetrabenazine are selective VMAT2 inhibitors specifically approved for tardive dyskinesia. They reduce dopamine release from presynaptic terminals without the psychiatric side effects (depression, suicidality) associated with tetrabenazine. The KINECT-3 trial (valbenazine) and ARM-TD/AIM-TD trials (deutetrabenazine) demonstrated significant reduction in TD severity. They represent the first medications specifically approved and licensed for TD. A: Tetrabenazine is used off-label but has more psychiatric side effects. C: Botulinum toxin may help focal symptoms but does not address the generalised condition. D: Levodopa would worsen TD. E: Clonazepam may provide modest benefit but is not specifically approved.

Reference: FDA/EMA Valbenazine and Deutetrabenazine Approvals; KINECT-3 Trial