Valbenazine (Ingrezza): The First FDA-Approved Treatment for Tardive Dyskinesia

Tardive dyskinesia (TD) is a spectrum of hyperkinetic movement disorders associated with the use of dopamine receptor blocking agents. Among the dopamine receptor blockers, neuroleptics or antipsychotics have been the drugs most frequently associated with TD. 1 The diagnosis of TD, as set forth by the Diagnostic and Statistical Manual of Mental Disorders , fourth edition, text revision, requires ruling out other potential medical conditions; exposure to an antipsychotic for at least four weeks; and the presence of physical symptomatology. 2 Involuntary athetoid or choreiform movements of the tongue, lips, face, and extremities are classic characteristics of TD and may appear one to two years into treatment with dopamine receptor blockers. Routine use of the Abnormal Involuntary Movement Scale (AIMS) is widely accepted for detecting or evaluating the severity of dyskinesia in patients receiving chronic antipsychotic therapies. 3 The primary pathophysiology of TD is unknown; etiologies that have been investigated include dopamine receptor super-sensitivity, gamma-aminobutyric acid hypofunction, and neurodegeneration. 2 , 4