Tetrabenazine in the treatment of hyperkinetic movement disorders

Tetrabenazine in the treatment of hyperkinetic movement disorders Tetrabenazine (TBZ) is a centrally acting depletor of the monoamines dopamine, norepinephrine, and serotonin. It reversibly blocks the vesicular monoamine transporter VMAT-2 and has only mild D-2-receptor blocking properties. It is used successfully in hyperkinetic movement disorders including chorea as in Huntington's disease (HD) and other aetiologies, tardive dyskinesias (TD), tics, dystonias, myoclonus and cerebral palsy. Chorea and TD are studied best and yield best therapeutic results. In 2007 tetrabenazine was approved in Germany as Nitoman (R) for the treatment of HD-chorea and TD. Tetrabenazine is generally well tolerated. However, depression, parkinsonism, and dysphagia can occur. Tetrabenazine is the only drug that offers robust therapeutic efficacy based upon indirect D-2-antagonism, lack of TD risk and lack of peripheral adverse effects.