From the Guidelines
Ingrezza (Valbenazine) should not be prescribed to patients without Tardive Dyskinesia (TD) as it may expose them to potential side effects without any therapeutic benefit. The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia, published in 2020 1, emphasizes the importance of evidence-based treatments and careful assessment of patients' symptoms and treatment history. Ingrezza is specifically FDA-approved for treating TD, a movement disorder characterized by involuntary, repetitive movements that typically occurs as a side effect of long-term antipsychotic medication use.
Key Points to Consider
- Ingrezza works by selectively inhibiting vesicular monoamine transporter 2 (VMAT2), which regulates dopamine release in the brain, a mechanism targeted to address the specific neurochemical imbalances present in TD.
- Taking Ingrezza without having TD exposes patients to potential side effects such as somnolence, anticholinergic effects, balance problems, and QT prolongation without any therapeutic benefit.
- The medication is expensive, costing thousands of dollars monthly, and insurance would likely deny coverage for off-label use in patients without confirmed TD.
- If a patient is concerned about movement disorders or other neurological symptoms, they should seek proper diagnosis and appropriate treatment options specific to their actual condition, as recommended by the APA guideline 1.
Clinical Implications
- Clinicians should carefully assess patients' symptoms and treatment history before prescribing any medication, including Ingrezza.
- Patients with schizophrenia should be treated with evidence-based nonpharmacological and pharmacological treatments, as recommended by the APA guideline 1.
- Ingrezza should only be prescribed to patients with confirmed TD, and patients should be monitored for effectiveness and side effects, as recommended by the APA guideline 1.
From the Research
Harmfulness of Ingrezza (Valbenzine) in Patients without Tardive Dyskinesia (TD)
- There is no direct evidence in the provided studies to suggest that Ingrezza (Valbenzine) is harmful in patients without Tardive Dyskinesia (TD) 2, 3, 4, 5, 6.
- The studies primarily focus on the treatment of Tardive Dyskinesia with Valbenazine, and its effectiveness in improving TD symptoms 3, 5, 6.
- The mechanism of action of Valbenazine, as a highly selective inhibitor of the VMAT2 vesicular monoamine transporter, is described in the studies, but its effects on patients without TD are not explicitly discussed 5, 6.
- The FDA approval of Valbenazine for the treatment of TD in adults is mentioned in the studies, but there is no information on its use or effects in patients without TD 3, 5, 6.
- Overall, the provided studies do not provide sufficient information to determine the potential harm of Ingrezza (Valbenzine) in patients without Tardive Dyskinesia (TD) 2, 3, 4, 5, 6.