Time to Onset of Action for Ingrezza (Valbenazine)
Ingrezza (valbenazine) demonstrates a rapid onset of effect within 2 weeks of treatment initiation for tardive dyskinesia. 1
Clinical Timeline
Initial response: Valbenazine shows therapeutic benefit within 2 weeks of starting treatment, which is notably faster than many other psychiatric medications 1
Week 6 assessment: By the end of 6 weeks of treatment, patients demonstrate significant improvement in abnormal involuntary movements, with dose-dependent reductions in AIMS (Abnormal Involuntary Movement Scale) scores 2, 3
Long-term improvement: Continued treatment up to 48 weeks shows sustained and progressive TD improvement, with most patients (approximately 90%) achieving ≥50% improvement from baseline 4
Dosing Considerations
Treatment typically begins at 40 mg once daily, with potential escalation to 80 mg once daily at week 4 based on efficacy and tolerability 4
A 60 mg dose is also available and provides efficacy between the 40 mg and 80 mg doses, offering an intermediate option for dose optimization 5
The once-daily dosing schedule represents a practical advantage for medication adherence 1
Important Clinical Caveat
Discontinuation leads to symptom re-emergence: After valbenazine washout (4 weeks post-discontinuation), AIMS scores return toward baseline levels, indicating that TD symptoms re-emerge when treatment is stopped 2, 3. This underscores the need for continued treatment to maintain therapeutic benefit.
Mechanism Supporting Rapid Onset
Valbenazine is a highly selective vesicular monoamine transporter 2 (VMAT2) inhibitor that decreases abnormal movements by reducing dopamine release at the synapse 1. This mechanism allows for relatively quick therapeutic action compared to medications requiring weeks to months for effect.