tetrabenazine / Generic mfg. - LARVOL DELTA

Non-ketotic hyperglycaemic hemichorea as the first manifestation of undiagnosed diabetes mellitus in an elderly patient. (PubMed, Endocrinol Diabetes Metab Case Rep) - "Treatment with insulin, haloperidol, and tetrabenazine achieved a gradual symptomatic improvement, with a marked reduction in involuntary movements at three months, although resolution was protracted compared to the typical cases. Some patients can achieve symptom resolution by glucose control alone. However, the majority require additional anti-chorea medications."

Journal • CNS Disorders • Diabetes • Metabolic Disorders • Movement Disorders • Vascular Neurology

IMMUNE-MEDIATED CHOREA IN ANTIPHOSPHOLIPID SYNDROME: NORMALIZATION OF FDG-PET AND NEUROFILAMENT AS MARKERS OF TREATMENT RESPONSE. (ADPD 2026) - "Treatment was started with anticoagulation, corticosteroids, Rituximab, and tetrabenazine for chorea. APL-related chorea often lacks structural lesion correlation, aligning with a more functional immune-mediated basal-ganglia disruption theory. In our case, normalization of FDG-PET metabolism and elevated neurofilament levels after treatment reinforce the reversibility of inflammatory neuronal dysfunction, highlighting the importance of early recognition and individualized treatment."

FDG PET • Alzheimer's Disease • Ataxia • Brain Cancer • CNS Disorders • Cognitive Disorders • Genetic Disorders • Immunology • Inflammatory Arthritis • Mood Disorders • Movement Disorders • Vasculitis

Management of Status Dystonicus in the PICU: A Scoping Review of Recent Literature (SCCM 2026) - "There is broad agreement, with some regional variation, on the medical management, with antipyretics, analgesia, sedation (lorazepam), anticholinergics (trihexyphenidyl), muscle relaxants (primarily baclofen and benzodiazepines), alpha-2-adrenergic agonists (clonidine, tizanidine), and the vesicular monoamine transporter (VMAT2) tetrabenazine. Titratable infusions, including midazolam, dexmedetomidine, opioids, and pentobarbital may be needed... Prevention of SD episodes is key. A multidisciplinary, systematic approach to care is essential, with the input of medical, surgical and other subspecialists. Early consideration of interventional approaches in critically ill children with SD is warranted."

Review • CNS Disorders • Dystonia • Infectious Disease • Movement Disorders • Respiratory Diseases • Sleep Disorder

Progressive Chorea Responsive to Immunotherapy: Anti-CASPR2 Antibody Encephalitis Initially Misdiagnosed as Huntington's Disease (AAN 2026) - "He was able to discontinue tetrabenazine. Maintenance immunotherapy was started with rituximab, and mycophenolate was added as he did not feel rituximab was adequate. This case illuminates the value of considering immune-driven pathogenesis in newly diagnosed movement disorders."

IO biomarker • CNS Disorders • Dystonia • Huntington's Disease • Movement Disorders • Sleep Disorder

Consensus Molecules Associated with Parkinson's Disease. (PubMed, Neurol Int) - "Drugs include L-dopa (49%), carbidopa (63%), benserazide (50%), entacapone (74%), tolcapone (56%), rasagiline (76%), selegiline (46%), pargyline (4%), ropinirole (61%), pramipexole (56%), lisuride (27%), cabergoline (16%), bromocriptine (12%), and zonisamide (9%). Adjunctive therapies include droxidopa (33%), trihexyphenidyl (28%), biperiden (17%), amantadine (24%), memantine (7%), rivastigmine (13%), donepezil (6%), galantamine (4%), domperidone (6%), clonazepam (4%), tetrabenazine (16%), mazindol (13%), quetiapine (6%), and clozapine (4%). Contraindicated drugs include haloperidol (4%), sulpiride (3%), and methyldopa (6%)...Chemical inducers of PD include 6-hydroxydopamine (40%), N-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 78%), tetrahydropyridine (77%), probenecid (4%), quinolinic acid (4%), 1,2,3,4-tetrahydroisoquinoline (TIQ, 16%), salsolinol (32%), rotenone (25%), and β-Methylamino-L-alanine (BMAA, 29%). Notably, our study highlights conditional essential..."

Journal • Review • CNS Disorders • Movement Disorders • Parkinson's Disease

Safety and efficacy of VMAT2 inhibitors in Huntington Disease: A systematic review. (PubMed, Parkinsonism Relat Disord) - "This systematic review shows VMAT2 inhibitors significantly reduce chorea severity in HD. While tetrabenazine showed the greatest reduction in chorea scores, valbenazine and deutetrabenazine provided broader benefits on functional outcomes and improvement scales. Tetrabenazine had the highest rate of AEs, whereas deutetrabenazine demonstrated favorable tolerability, with fewer complications. Valbenazine demonstrated an intermediate safety profile. These differences should guide individualized treatment decisions in clinical practice."

Journal • Review • Genetic Disorders • Huntington's Disease • Movement Disorders

The Use of VMAT2 Inhibitors for Tardive Dyskinesia. (PubMed, J Clin Psychopharmacol) - "TD remains underdiagnosed, with treatment rates low, highlighting the need for improved TD recognition and VMAT2-I access."

Journal • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Movement Disorders • Psychiatry • Schizophrenia

Valbenazine induced acute parkinsonism in a patient with alcohol use disorder and central pontine myelinolysis. (PubMed, PCN Rep) - "The patient was treated with tetrabenazine and valbenazine at different times, and only valbenazine treatment induced acute parkinsonism. Valbenazine can cause acute parkinsonism, even in patients who have previously tolerated tetrabenazine, and especially in those with underlying basal ganglia lesions."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Movement Disorders • Parkinson's Disease • Psychiatry

Optimization of Ionic Liquid Based NLC for Nose-To-Brain Delivery of Tetrabenazine Hydrochloride. (PubMed, AAPS PharmSciTech) - "Conclusively, the nose-to-brain delivery of TBZ-loaded Hybrid-NLCs gel significantly enhanced TBZ bioavailability to the brain, 1.51-fold over Plain-NLCs gel. Findings underscored Hybrid-NLCs as a promising non-invasive strategy for enhancing the bioavailability of BCS class IV drugs via nose to brain delivery, prospective in the treatment of neurological diseases/disorders."

Journal • CNS Disorders

Small Gold Nanoparticles Alleviate Huntington's Disease via Modulating p38α Mitogen-Activated Protein Kinase and Pyruvate Dehydrogenase Kinase 1. (PubMed, ACS Nano) - "Devoid of known chemical or biological drugs, this NP improves motor deficit as effectively as tetrabenazine (standard therapy for symptomatic relief) and prolongs survival, without long-term brain retention or systemic toxicity. This NP activates the oxidative phosphorylation pathway, blocks p38α mitogen-activated protein kinase phosphorylation and pyruvate dehydrogenase kinase 1 activity, and inhibits pyroptosis. Our data offer molecular insights into gold nanomedicines against neurodegenerative diseases."

Journal • CNS Disorders • Huntington's Disease • Movement Disorders

Physician experience and perceptions of tetrabenazine for the treatment of tardive dyskinesia and Huntington's chorea: a survey of neurologists and psychiatrists. (PubMed, Expert Rev Neurother) - "Additionally, 18% and 25% reported that they were often/almost always unable to titrate TBZ to optimal doses because of side effects and 24% and 15% reported that side effects often/almost always led to TBZ discontinuation. Although most physicians were moderately satisfied with TBZ, they also reported that TBZ side effects prevented reaching optimal clinical effectiveness and often led to discontinuation, suggesting a need for additional effective treatment options with favorable benefit-risk profiles for TD and HD-related chorea."

Journal • Genetic Disorders • Huntington's Disease • Movement Disorders • Psychiatry

Tetrabenazine-induced miR-34a-5p suppresses the tumorigenicity of radioresistant colorectal cancer by inhibiting M2 macrophage polarization. (PubMed, Cell Commun Signal) - "TBZ reduces tumorigenicity via the regulation of the p53-miR-34a-5p/Snail axis in radioresistant CRC cells and suppression of M2 macrophage polarization, decreasing IL-10 secretion. Our study provides insight into drug repurposing by revealing the mechanism by which TBZ, an FDA-approved drug, reduces tumorigenicity through communication between radioresistant CRC cells and macrophages."

Journal • Colorectal Cancer • Oncology • Solid Tumor • IL10 • MIR34A • SNAI1 • TP53

Tetrabenazine-Induced Rapid-Onset Suicidality in an Adolescent With Schizophrenia and Obsessive-Compulsive Disorder. (PubMed, Prim Care Companion CNS Disord) - No abstract available

Journal • CNS Disorders • Mood Disorders • Obsessive-Compulsive Disorder • Psychiatry • Schizophrenia

Theta oscillations vary with local response rate and are moderated by the dopamine-depleting agent, tetrabenazine, during effort-based behavior. (PubMed, Cogn Affect Behav Neurosci) - "We determined that the behavioral effects of TBZ were correlated with these neurophysiological changes across animals. Taken together, these findings demonstrate how TBZ may affect both theta dynamics and effortful behavior and suggest that the amplitude and frequency of theta band may vary with exertion of effort in motivated behavior."

Journal

When Stroke Mimics a Subthalamic Lesion: An Unusual Presentation of Hemichorea-Hemiballismus. (PubMed, Cureus) - "The patient was initiated on antiplatelet therapy for secondary stroke prevention and tetrabenazine for the symptomatic management of involuntary movements. This case underscores the diverse anatomical substrates and the evolving understanding of the pathophysiological mechanisms underlying HCHB."

Journal • Cardiovascular • Ischemic stroke • Movement Disorders

Refractory tardive dyskinesia in the critical care setting: A case report of successful use of phenobarbital. (PubMed, SAGE Open Med Case Rep) - "Despite withdrawal of antipsychotics, a trial of deutetrabenazine, and high-dose tetrabenazine (150 mg/day for several weeks), symptoms persisted and significantly impaired critical care management. Given phenobarbital's activity on Gamma Aminobutyric Acid B receptors, its mechanism may involve modulation of GABAergic pathways implicated in the pathophysiology of tardive dyskinesia. Further investigation in clinical studies is warranted."

Journal • CNS Disorders • Critical care • Movement Disorders • Psychiatry • Schizophrenia

The role of the vesicular monoamine transporter 2 in the inhibitory effect of tetrabenazine and valbenazine compared to reserpine on the vesicular release of monoamine transmitters. (PubMed, Front Cell Neurosci) - "TBZ and VBZ are compared to RSP in that they also inhibit the vesicular release of neurotransmitters and storage capacity; however, their activity is less effective and is of much shorter duration, leaving some time for vesicle refilling. The difference observed between the two types of VMAT-2 inhibitors might give some explanation of why, in response to TBZ or VBZ treatment, the occurrence of depression or Parkinsonism as side effects is seen very rarely or not at all, and in the case of RSP, it is relatively frequent."

Journal • CNS Disorders • Depression • Movement Disorders • Parkinson's Disease • Psychiatry

Characterisation of a touchscreen-based task for assessing cognitive judgement bias in mice: a new translational tool for affective state disorder drug screening. (PubMed, Psychopharmacology (Berl)) - "This study underscores the capacity of mice to respond to visually ambiguous stimuli in an ambiguity-dependent manner, a phenomenon observed across various species, including humans. Furthermore, it establishes and validates an operant behavioural task to assess CJB in mice delivered using the touchscreen platform, which has significant cross-species translational potential."

Journal • Preclinical • CNS Disorders • Depression • Psychiatry

Exploring the Healthcare Resource Utilization (HCRU) Associated With Chorea in Patients With Huntington's Disease (HD): A Systematic Literature Review (SLR) (ISPOR-EU 2025) - "Risperidone was the most prescribed (26%), tetrabenazine (17%), other (6%), risperidone + tetrabenazine (6%), and deutetrabenazine (2%). Chorea imposes a substantial HCRU burden on patients with HD, which increases with chorea severity. Chorea imposes a substantial HCRU burden on patients with HD, which increases with chorea severity. Patients with the most severe chorea require more healthcare resources and experience greater impairments in work/daily functioning. Despite VMAT2 inhibitors being the only approved treatments for chorea in HD, their use remains limited—potentially due to costs."

Clinical • HEOR • Review • CNS Disorders • Huntington's Disease • Movement Disorders • Psychiatry

Molecular basis of vesicular monoamine transport and neurological drug interactions. (PubMed, Cell Rep) - "Here, we report cryo-electron microscopy structures of human VMAT2 capturing a cytoplasmic-open state with reserpine and lumenal-facing states with serotonin and histamine in open, amphetamine in less open, tetrabenazine in fully occluded, and unbound VMAT2 in partially occluded conformations. Liposome-based analyses demonstrate that amphetamine directly induces the release of a fluorescent monoamine analog via VMAT2, consistent with an exchange mechanism underlying psychostimulation. These findings reveal the molecular basis of monoamine storage and drug interactions by VMAT2, informing therapeutic development for neurological diseases and substance abuse."

Journal • CNS Disorders • Substance Abuse

Spectacular shrinking deficit followed by delayed Hemichorea-Hemiballismus: Redefining the stroke-TIA spectrum. (PubMed, eNeurologicalSci) - "Neuroimaging revealed T1 hyperintensities in the right striatum without contrast enhancement, subtle diffusion abnormalities, and focal right MCA stenosis, while metabolic workup ruled out hyperglycemic chorea. The patient's refractory symptoms responded uniquely to tetrabenazine, further supporting an ischemic rather than metabolic etiology."

Journal • Cardiovascular • Diabetes • Movement Disorders

Hyperglycaemia Presenting With Hemichorea: A Rare Case of Diabetic Striatopathy With Ketosis. (PubMed, Cureus) - "Tetrabenazine was also started...Therefore, it should be considered in the list of differential diagnoses in any diabetic patient presenting with a movement disorder, even outside the typical Asian demographic and non-ketotic setting. Prompt diagnosis prevents misclassification as an intra-cerebral haemorrhage and facilitates timely management with an excellent prognosis."

Journal • Atrial Fibrillation • Cardiovascular • Diabetes • Metabolic Disorders • Movement Disorders • Oncology • Pancreatic Cancer • Type 2 Diabetes Mellitus

Effectiveness of 40-Session Repetitive Transcranial Magnetic Stimulation in Tourette Syndrome: A 6-Month Follow-Up Case Report. (PubMed, Turk Psikiyatri Derg) - "Pharmacological treatment included escitalopram (10 mg/day), followed sequentially by pimozide (4 mg/day), tetrabenazine (3*25 mg/day), and aripiprazole (10 mg/day). This report suggests that rTMS may be a promising alternative for TS patients with psychiatric comorbidities, particularly those who cannot tolerate medications or achieve sufficient symptom control through pharmacotherapy alone. Keywords: Tourette’s Syndrome, Repetitive Transcranial Magnetic Stimulation, Supplementary Motor Area."

Journal • CNS Disorders • Developmental Disorders • General Anxiety Disorder • Mood Disorders • Movement Disorders • Psychiatry • Tourette Syndrome

Efficacy and safety of vesicular monoamine transporter 2 inhibitors for Huntington's disease chorea based on network meta-analysis. (PubMed, Front Pharmacol) - "Three VMAT2 inhibitors, including tetrabenazine, deutetrabenazine and valbenazine were investigated. Tetrabenazine is the most effective in controlling chorea, whereas valbenazine may be the optimal choice for patients with comorbid psychiatric symptoms. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251012431, identifier CRD420251012431."

Journal • Retrospective data • Review • Huntington's Disease • Movement Disorders • Psychiatry • Suicidal Ideation

Managing Dystonia in Partington Syndrome. (PubMed, Mov Disord Clin Pract) - "Treatment options in Partington syndrome-associated dystonia remain elusive. Further research and additional case studies are needed to fully characterize the clinical features of Partington syndrome and to identify effective treatments."

Journal • Review • CNS Disorders • Developmental Disorders • Dystonia • Mental Retardation • Movement Disorders