Long-term tolerability of tetrabenazine in the treatment of hyperkinetic movement disorders.
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.
Kenney
Christopher
C
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA. kenney@bcm.edu
Hunter
Christine
C
Jankovic
Joseph
J
D000328:Adult; D017668:Age of Onset; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004361:Drug Tolerance / Q000502:physiology; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006948:Hyperkinesis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013747:Tetrabenazine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D020323:Tics / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D013995:Time
D018726:Anti-Dyskinesia Agents; D013747:Tetrabenazine