Efficacy and Safety of Deutetrabenazine and Valbenazine in Tardive Dyskinesia

Both VMAT2 inhibitors have been evaluated in randomized, placebo controlled trials, though no head to head comparison exists. The panel explains that efficacy is often best understood through number needed to treat. For valbenazine, the NNT is seven at 40 mg and four at 80 mg. Deutetrabenazine demonstrates similar benefit, with an NNT of approximately five. Clinical response generally requires six to twelve weeks, and both medications show durability in long term studies. However, washout phases demonstrate symptom return, reinforcing that these drugs improve movements but do not cure tardive dyskinesia. The panel highlights the importance of counseling patients about realistic expectations, the likelihood of lifelong therapy if effective, and the need to discuss adverse effects openly. Cost and access challenges may influence initiation, often requiring coordination with neurology and pharmacy teams.