From the FDA Drug Label
- 2 Reserpine Reserpine binds irreversibly to VMAT2 and the duration of its effect is several days. Prescribers should wait for chorea or dyskinesia to reemerge before administering AUSTEDO XR or AUSTEDO to help reduce the risk of overdosage and major depletion of serotonin and norepinephrine in the central nervous system At least 20 days should elapse after stopping reserpine before starting AUSTEDO XR or AUSTEDO.
The main consideration for overdose when taking deutetrabenazine is the risk of major depletion of serotonin and norepinephrine in the central nervous system, particularly when used concomitantly with reserpine. To reduce this risk, prescribers should:
- Wait for chorea or dyskinesia to reemerge before administering deutetrabenazine
- Ensure that at least 20 days have elapsed after stopping reserpine before starting deutetrabenazine 1 1.
From the Research
Overdose of deutetrabenazine requires immediate medical attention, and treatment is primarily supportive, focusing on managing symptoms, as there is no specific antidote available. If an overdose is suspected, call poison control (1-800-222-1222) or seek emergency care right away. Symptoms of overdose may include severe drowsiness, confusion, agitation, restlessness, significantly slowed or difficult breathing, unusual dizziness, fainting, severe muscle stiffness or twitching, very high fever, irregular heartbeat, or seizures. According to a recent study 2, deutetrabenazine has a relatively low side effect profile, but adverse events can occur, particularly in the central nervous system and cardiovascular system.
Key Considerations
- Deutetrabenazine works by depleting monoamines in the brain, particularly dopamine, so overdose effects primarily involve the central nervous system and cardiovascular system.
- Healthcare providers may use activated charcoal if the overdose was recent, monitor vital signs, provide respiratory support if needed, and treat specific symptoms as they arise.
- Patients taking deutetrabenazine should store the medication securely, take only the prescribed dose, and never share it with others to prevent accidental overdose.
- A case study 3 reported a benign presentation following a massive deutetrabenazine overdose, highlighting the importance of awareness and monitoring for potential side effects.
Prevention and Management
- Patients should be educated on the proper use and storage of deutetrabenazine to prevent accidental overdose.
- Regular monitoring of patients taking deutetrabenazine is crucial to detect potential adverse events early and manage them effectively.
- In cases of overdose, supportive treatment and symptom management are essential to prevent long-term morbidity and mortality.