Tetrabenazine

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Tetrabenazine
Systematic (IUPAC) name
1,3,4,6,7,11b-Hexahydro- 9,10-dimethoxy-3- (2-methylpropyl)- 2H-benzo[a]quinoline; Ro-1-9569
Identifiers
CAS number	58-46-8
ATC code	N05AK01
PubChem	6018
Chemical data
Formula	C19H27NO3
Mol. mass	317.427
Pharmacokinetic data
Bioavailability	?
Metabolism	?
Half life	?
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status	Orphan drug
Routes	tablets: 25 mg

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Tetrabenazine is a drug for the symptomatical treatment of hyperkinetic movement disorder and is marketed under the trade names Nitoman® in Canada and Xenazine® in New Zealand and some parts of Europe, and is also available in the USA as an orphan drug. The compound is known since the 1950s. Tetrabenazine works mainly as a VMAT-inhibitor and as such promotes the early metabolic degradation of the neurotransmitter dopamine.

Common uses

Tetrabenazine is used as a treatment, but not a cure for hyperkinetic disorders such as:

• Huntington's Disease - specificially the chorea associated with it
• Tourette's Syndrome and other tic disorders
• Tardive dyskinesia, a serious and sometimes irreversible side effect of long-term use of many antipsychotics, mainly typical antipsychotics
• Hemiballismus, spontaneous flinging limb movements due to subthalamic nucleus damage

Side effects

Because tetrabenazine is closely related to the antipsychotics, many of its side effects are similar. Some of these include:

• Akathisia (aka "restless pacing" - an inability to keep still, with intense anxiety when forced to do so)
• Depression - the most common side effect, reported in roughly 15% of those who take the medication
• Dizziness/drowsiness
• Parkinsonism

Unlike many of the antipychotics, tetrabenazine is not known to cause Tardive dyskinesia, and in fact can be an effective treatment for the antipsychotic-induced movement disorder.

Warnings

• Because of the relatively high incidence of depression, it has been recommended that people with a history of depression avoid taking tetrabenazine. Research into this is ongoing however, and this warning may be dropped in the future.
• The concomitant intake of MAO inhibitors is contraindicated.

References

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