Awareness of Multiple Treatment Options for Tardive Dyskinesia: Tips from Dr Jonathan Meyer

CONFERENCE REPORTER

At the Southern California Psychiatry Conference, Jonathan Meyer, MD discussed treatment for tardive dyskinesia, maintaining that “the only effective treatments for tardive dyskinesia are the VMAT 2 inhibitors.”¹ Previously, clinicians tended to use the same medications to combat all movement disorders in the D2 blockade, he recalled. But, these commonly prescribed items are ultimately not effective for tardive dyskinesia (TD), Meyer said. Meyer noted that often, using these same medications to treat TD can actually worsen symptoms.

In transferring patients from anticholinergics to these more beneficial VMAT 2 inhibitors, clinicians should be sure to taper off anticholinergics slowly to allow ideal symptom reduction of movement disorders. A key element of VMAT 2 inhibitors is the goal to “improve…quality of life related to tardive dyskinesia,” Meyer said. One of the treatments, deutetrabenazine, has a stricter titration schedule and is recommended to start at lower doses. On the other hand, valbenazine is easier to begin treatment with at a lower starting dose while still being effective.²

Meyer noted to clinicians that “you need to know how to use both, simply because insurance, more than anything, may dictate what you have access to.” Knowing how to use both medication options benefits patients, as one person may respond differently than another or a patient may have different tolerability between medications. Meyer also acknowledged that with only 2 FDA approved medications for treating TD, “there are a subset of people with TD who don’t get adequate improvement with either of the 2 FDA licensed medications, and those are the types of people we may refer on to a neurologist for further evaluation and treatment.”

Dr Meyer is a voluntary clinical professor of psychiatry at the University of California, San Diego.

References

1. Meyer J. Dopamine dysfunction underlying schizophrenia, limitations of D2 blockade. Conference Proceedings of the Southern California Psychiatry Conference. July 2025;11-12. Huntington Beach, CA.

2. Touma KBT, Scarff JR. Valbenazine and deutetrabenazine for tardive dyskinesia. Innov Clin Neurosci. 2018;15(5-6):13-16.