What Should I Know About INGREZZA?
What specific movement disorders does Ingrezza treat?
Ingrezza (valbenazine) is specifically approved by the FDA for the treatment of tardive dyskinesia (TD) and chorea associated with Huntington's disease.
Ingrezza works by selectively inhibiting the vesicular monoamine transporter 2 (VMAT2). VMAT2 is primarily responsible for transporting monoamines (like dopamine, serotonin, norepinephrine, and histamine) from the cytoplasm of nerve terminals into synaptic vesicles for storage and release. By inhibiting VMAT2, Ingrezza reduces the amount of dopamine released into the synapse. Because an overactivity of dopamine signaling is thought to contribute to the involuntary movements associated with tardive dyskinesia and Huntington's disease chorea, Ingrezza helps to reduce these movements. Tardive dyskinesia is a movement disorder characterized by repetitive, involuntary movements, most often affecting the face, mouth, tongue, and jaw. It is typically caused by long-term treatment with certain medications, such as antipsychotics used to treat mental health conditions. Huntington's disease chorea is characterized by involuntary, jerky movements that are associated with Huntington's disease, a progressive neurodegenerative disorder. Ingrezza is not a cure for either of these disorders, but it can help to manage the symptoms and improve the quality of life for individuals affected by them.Is Ingrezza used for Tourette's syndrome?
No, Ingrezza (valbenazine) is not currently approved by the FDA for the treatment of Tourette's syndrome. It is specifically approved for the treatment of adults with tardive dyskinesia and chorea associated with Huntington's disease.
Ingrezza works by selectively inhibiting vesicular monoamine transporter 2 (VMAT2), which reduces the amount of dopamine released in the brain. While the underlying mechanisms of Tourette's syndrome are complex and not fully understood, dopamine dysregulation is thought to play a role. Although other VMAT2 inhibitors, such as tetrabenazine and deutetrabenazine, are sometimes used off-label to manage tics associated with Tourette's, Ingrezza itself has not been studied extensively for this purpose, and clinical trials are needed to evaluate its safety and efficacy in individuals with Tourette's.
It's important to consult with a qualified healthcare professional to determine the most appropriate treatment options for Tourette's syndrome. Several other medications and therapies, including alpha-adrenergic agonists, antipsychotics, and behavioral interventions like Comprehensive Behavioral Intervention for Tics (CBIT), are commonly used to manage tics and associated symptoms. A doctor can assess individual needs and recommend a personalized treatment plan.
How does Ingrezza work to reduce tardive dyskinesia symptoms?
Ingrezza (valbenazine) reduces tardive dyskinesia (TD) symptoms by selectively inhibiting vesicular monoamine transporter 2 (VMAT2). VMAT2 is a protein responsible for packaging and transporting monoamines, such as dopamine, from the cytoplasm into synaptic vesicles in nerve terminals. By inhibiting VMAT2, Ingrezza reduces the amount of dopamine released into the synapse, thereby mitigating the excessive dopamine signaling thought to contribute to the involuntary movements characteristic of TD.
Essentially, Ingrezza acts as a dopamine regulator rather than a dopamine blocker. Traditional antipsychotics, which are often implicated in causing TD, work by blocking dopamine receptors. This can lead to the brain compensating by upregulating these receptors, making them more sensitive to dopamine. When the antipsychotic is stopped or the dosage reduced, the now-hypersensitive receptors can overreact to normal dopamine levels, causing TD. Ingrezza, by decreasing the amount of dopamine available for release, helps to normalize dopamine signaling without directly blocking receptors, potentially reversing some of the changes that contribute to TD. The selectivity of Ingrezza for VMAT2 is also crucial. While there is another similar transporter, VMAT1, VMAT2 is the predominant transporter in the brain. This selectivity helps minimize off-target effects and contributes to Ingrezza's relatively favorable side effect profile compared to older treatments for TD. Reducing the presynaptic release of dopamine is thought to provide symptomatic relief from TD without causing the more profound dopamine blockade that can lead to other motor side effects or worsen underlying psychiatric conditions.What is the typical dosage of Ingrezza for tardive dyskinesia?
The typical starting dosage of Ingrezza (valbenazine) for the treatment of tardive dyskinesia (TD) is 40 mg once daily. After one week, the dosage is usually increased to the recommended maintenance dosage of 80 mg once daily. However, some individuals may be maintained on 40 mg once daily depending on tolerability and clinical response.
Ingrezza's dosing schedule is relatively straightforward, designed for ease of adherence. The initial lower dose of 40mg allows patients to acclimate to the medication and for clinicians to assess for any potential adverse effects. This titration strategy aims to minimize the risk of side effects that could occur with a sudden introduction of the full 80mg dose. The treating physician will consider factors such as pre-existing medical conditions, other medications the patient is taking, and the severity of the TD symptoms when determining the optimal dosage. It's important to note that Ingrezza dosage may need to be adjusted based on individual patient factors, such as those with moderate or severe liver impairment. In such cases, the maximum recommended dosage is 40 mg once daily. Patients should never adjust their dosage without consulting their healthcare provider. Furthermore, Ingrezza can be taken with or without food. Regular follow-up appointments with the prescribing physician are crucial to monitor the patient's response to treatment and to make any necessary dosage adjustments to achieve the best possible outcome.Can Ingrezza be used to treat Huntington's disease chorea?
Yes, Ingrezza (valbenazine) is approved by the FDA for the treatment of chorea associated with Huntington's disease. It is specifically designed to reduce the involuntary movements characteristic of this condition and can significantly improve the quality of life for individuals affected by Huntington's disease chorea.
Ingrezza works by selectively inhibiting vesicular monoamine transporter 2 (VMAT2). VMAT2 is a protein responsible for transporting monoamines (like dopamine, serotonin, and norepinephrine) from the cytoplasm of nerve cells into synaptic vesicles for storage and release. By inhibiting VMAT2, Ingrezza reduces the amount of dopamine released into the synapse. Since excessive dopamine activity in certain brain regions is thought to contribute to chorea, this reduction helps to alleviate the involuntary movements. While Ingrezza is effective for many patients, it's important to note that individual responses can vary. A healthcare professional will assess the patient's specific needs and medical history to determine if Ingrezza is the appropriate treatment option and to monitor for potential side effects. Common side effects can include sleepiness, fatigue, and nausea. As with any medication, it’s vital to discuss potential risks and benefits with a physician to make an informed decision.What are the common side effects associated with Ingrezza?
The most common side effects associated with Ingrezza (valbenazine) include sleepiness (somnolence), balance difficulties or falls, headache, nausea, dry mouth, constipation, and blurred vision. These side effects are generally mild to moderate in severity and often diminish with continued use.
While Ingrezza is generally well-tolerated, it's important to be aware of the potential for adverse reactions. The somnolence can impact daily activities requiring alertness, such as driving or operating machinery. The risk of falls is particularly important for elderly patients who may be more susceptible to balance problems. If you experience significant drowsiness, dizziness, or lightheadedness, it's crucial to discuss these symptoms with your doctor. Beyond the more common side effects, there is also a potential for more serious, though less frequent, adverse events. These include QT prolongation, a heart rhythm disturbance that can be dangerous, and neuroleptic malignant syndrome (NMS), a rare but life-threatening reaction to medications affecting the dopamine system. It's vital to promptly report any signs of NMS, such as high fever, muscle rigidity, altered mental status, and irregular heartbeat or blood pressure, to your healthcare provider. Patients with pre-existing heart conditions or those taking other medications that prolong the QT interval should be closely monitored while taking Ingrezza.How effective is Ingrezza compared to other treatments for tardive dyskinesia?
Ingrezza (valbenazine) is generally considered a highly effective treatment for tardive dyskinesia (TD), often demonstrating superior efficacy compared to older treatments and offering a more targeted mechanism of action. Clinical trials have consistently shown significant reductions in TD symptoms, as measured by scales like the Abnormal Involuntary Movement Scale (AIMS), in patients treated with Ingrezza compared to those receiving placebo or older medications.
Prior to the FDA approval of Ingrezza and Austedo (deutetrabenazine), treatment options for TD were limited and often involved off-label use of medications with limited efficacy and significant side effects. These older treatments, such as tetrabenazine, benzodiazepines, and botulinum toxin injections, might provide some symptomatic relief in certain cases but lacked the robust evidence base and generally favorable side effect profile seen with VMAT2 inhibitors like Ingrezza. Tetrabenazine, while also a VMAT2 inhibitor, requires more frequent dosing and carries a higher risk of side effects such as depression and parkinsonism compared to Ingrezza.
Ingrezza's effectiveness stems from its selective inhibition of vesicular monoamine transporter 2 (VMAT2), which reduces dopamine release in the brain. This targeted mechanism addresses the underlying dopamine supersensitivity believed to contribute to TD symptoms. Studies have demonstrated that a substantial proportion of patients treated with Ingrezza experience clinically meaningful improvements in their TD symptoms, leading to significant improvements in their quality of life and functional abilities. While individual responses may vary, Ingrezza represents a significant advancement in the treatment of TD, offering many patients a well-tolerated and effective option for managing this debilitating condition.
Hopefully, this gives you a better understanding of what Ingrezza is used for! It can be a real game-changer for some people dealing with tardive dyskinesia, but always chat with your doctor to see if it's the right fit for you. Thanks for stopping by, and we hope you'll come back again soon for more easy-to-understand health info!