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      Tetrabenazine in treatment of hyperkinetic movement disorders: an observational study

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          Abstract

          Background:

          Tetrabenazine (TBZ) is commonly used in hyperkinetic movement disorders. In this retrospective study, we aimed to assess the TBZ effectiveness and adverse events (AEs) in Huntington disease (HD), vascular chorea, tics, dystonia, tardive oromandibular (OM) dyskinesia and other tardive syndromes (TS).

          Methods:

          Qualitative analysis of clinical response was used to estimate TBZ effectiveness. TBZ-associated AE frequency and subsequent discontinuation rate were used to estimate tolerability; the tolerability profile was measured through the TBZ minimal dose and exposure time required to elicit AEs.

          Results:

          Of 108 included patients, 87% had a clinically meaningful improvement sustained over a period of 40 months. TBZ-responder rate ranged from 100% in HD to 62.5% and 77.1% in tic disorders and OM dyskinesia, respectively ( p < 0.001). TBZ-associated AE frequency ranged from 40.9% in other TS and 41.7% in vascular chorea and HD, to 60% in OM dyskinesia ( p < 0.001). The most common AEs were Parkinsonism (51.8%) and psychiatric disorders (25%). The ‘other AEs’ category (mainly somnolence) presented the shortest minimal exposure time (3 months). AE-eliciting dose differed from 18.8 mg and 25 mg in tics and tardive disorders, to 75 mg in HD ( p = 0.003). Patients with AEs were tendentiously older at TBZ initiation ( p = 0.022).

          Conclusions:

          TBZ proved an effective and relatively well tolerated treatment in hyperkinetic disorders, with excellent results in HD. AEs were more common in OM dyskinesia, which may be related to higher age at TBZ initiation. TBZ-associated somnolence and Parkinsonism were more frequent during the titration and maintenance periods, respectively.

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          Author and article information

          Contributors
          Journal
          Ther Adv Neurol Disord
          Ther Adv Neurol Disord
          TAN
          sptan
          Therapeutic Advances in Neurological Disorders
          SAGE Publications (Sage UK: London, England )
          1756-2856
          1756-2864
          21 November 2016
          February 2017
          : 10
          : 2
          : 81-90
          Affiliations
          [1-1756285616677004]Neurology Department, Hospital Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira, 126, 1349-019, Lisbon, Portugal
          [2-1756285616677004]Neurology Department, Hospital Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal CEDOC, Nova Medical School/ Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
          [3-1756285616677004]Neurology Department, Hospital Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
          [4-1756285616677004]Neurology Department, Hospital Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
          [5-1756285616677004]Neurology Department, Hospital Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
          [6-1756285616677004]Department of Neurology, Hospital Beatriz Ângelo, Avenida Carlos Teixeira, Loures, Portugal
          [7-1756285616677004]Neurology Department, Hospital Egas Moniz – Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal CEDOC, Nova Medical School/ Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
          Author notes
          Article
          PMC5367646 PMC5367646 5367646 10.1177_1756285616677004
          10.1177/1756285616677004
          5367646
          28382107
          43aa3c2e-4242-4245-9bc7-88e2f4e4affc
          © The Author(s), 2016
          History
          Categories
          Original Research

          tetrabenazine,dystonia,Huntington disease,oromandibular dyskinesia,tardive syndrome,tics

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