Safety Profile of VMAT2 Inhibitors and Impact on Treatment Selection
Panelists discuss how VMAT2 inhibitors' most commonly reported adverse effects include somnolence, fatigue, and mild parkinsonism symptoms, which can typically be managed through dose adjustments and careful titration strategies, while noting these side effects are generally less severe than those of older treatments and rarely lead to discontinuation when patients are properly monitored and educated about expectations.
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Long-Term Outcomes with VMAT2 Inhibitors
Panelists discuss how long-term open-label extension studies of VMAT2 inhibitors demonstrated sustained efficacy and tolerability of both deutetrabenazine (ARM-TD and AIM-TD extensions showing durable response over 3 years) and valbenazine (KINECT 4 showing maintained improvements through 48 weeks), with low discontinuation rates due to adverse events and no new safety signals emerging during extended treatment periods.
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Treatment Options for Tardive Dyskinesia
Panelists discuss how VMAT2 inhibitors deutetrabenazine and valbenazine have revolutionized TD treatment through their proven efficacy in reducing involuntary movements and favorable safety profiles, with clinical trials demonstrating significant symptom improvement as measured by AIMS scores while maintaining psychiatric stability and showing key differences in dosing schedules and titration approaches.
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Improving Outcomes Through Patient Education and Addressing Unmet Needs
Panelists discuss how comprehensive patient education about tardive dyskinesia risk factors, early warning signs, and available treatments is crucial for improving outcomes, while highlighting remaining unmet needs including better screening tools, enhanced provider training, expanded access to VMAT2 inhibitors, and more research into prevention strategies and novel therapeutic approaches.
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Impact of Tardive Dyskinesia on Quality of Life
Panelists discuss how untreated tardive dyskinesia severely impacts patients' daily functioning and quality of life through physical limitations affecting basic tasks like eating and walking, social isolation due to visible symptoms, and heightened risks for older adults who face increased fall risks, difficulty maintaining independence, and complications from age-related comorbidities.
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Panelists discuss how clinicians rely on careful observation, standardized rating scales like the AIMS (Abnormal Involuntary Movement Scale), and comprehensive patient histories to diagnose tardive dyskinesia, while facing challenges in distinguishing it from other movement disorders due to symptom overlap and the need to rule out conditions like drug-induced parkinsonism, akathisia, and primary movement disorders.
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