Long‐term tolerability of tetrabenazine in the treatment of hyperkinetic movement disorders

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Abstract
We sought to review the long‐term tolerability of tetrabenazine (TBZ) and seek determinants of tolerability in the treatment of hyperkinetic movement disorders. A retrospective chart review was performed on patients treated with TBZ between 1997 and 2004. Efficacy of TBZ was assessed by a 1‐ to 5‐point response scale (1 = marked reduction in abnormal movements, 5 = worsening). All adverse events (AEs) were captured according to their relationship with study drug. A total of 448 patients (42% male) were treated for a variety of hyperkinesias, including tardive dyskinesia (n = 149), dystonia (n = 132), chorea (n = 98), tics (n = 92), and myoclonus (n = 19). The mean age at onset of the movement disorder was 43.0 ± 24.2 years, with TBZ starting at a mean age of 50.0 ± 22.3 years. Patients remained on treatment for a mean of 2.3 ± 3.4 years. An efficacy response rating of 1 or 2 was sustained in the majority of patients between the first and last visit. Common AEs included drowsiness (25.0%), Parkinsonism (15.4%), depression (7.6%), and akathisia (7.6%). Comparison of log‐likelihood ratios revealed that age was a reliable predictor of Parkinsonism (P< 0.0001). TBZ is a safe and effective drug for the long‐term treatment of hyperkinetic movement disorders. © 2006 Movement Disorder Society

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