Abstract
Objectives
We aimed to review our “real-world” experience with the vesicular monoamine transporter 2 (VMAT2) inhibitors tetrabenazine, deutetrabenazine, and valbenazine for treatment of Tourette syndrome, focusing on therapeutic benefits, side effect profile, and accessibility for the off-label use of these drugs.
Methods
We performed a retrospective chart review, supplemented with a telephone survey, of all our patients treated for their tics with VMAT2 inhibitors over a period of 4 years from January 2017 until January 2021.
Results
We identified 164 patients treated with the various VMAT2 inhibitors (tetrabenazine, n = 135; deutetrabenazine, n = 71; valbenazine, n = 20). Data on the mean treatment duration and daily dosages were collected. The response to VMAT2 inhibitors was assessed by a Likert scale by comparing the symptom severity before initiation and while on treatment. Side effects were mild and mostly consisted of depression as the major side effect but there was no suicidality reported.
Conclusion
VMAT2 inhibitors are effective and safe in the treatment of tics associated with Tourette syndrome but are not readily accessible by patients in the United States, partly because of lack of approval by the Food and Drug Administration.
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As a co-author of this article I had full access to the data. Relevant data is available in the publication.
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Dr. Makhoul declares that he has no conflicts of interest. Dr. Jankovic has received research or training grants from AbbVie Inc; CHDI Foundation; Dystonia Coalition; Medtronic Neuromodulation; Merz Pharmaceuticals; Michael J Fox Foundation for Parkinson Research; National Institutes of Health; Parkinson’s Foundation; Revance Therapeutics, Inc; Teva Pharmaceutical Industries Ltd. Dr. Jankovic has served as a consultant for AbbVie Inc; Aeon BioPharma; Neurocrine; Revance Therapeutics; Teva Pharmaceutical Industries Ltd..
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Makhoul, K., Jankovic, J. Real-world experience with VMAT2 inhibitors in Tourette syndrome. J Neurol 270, 4518–4522 (2023). https://doi.org/10.1007/s00415-023-11769-0
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DOI: https://doi.org/10.1007/s00415-023-11769-0