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Over the past 15 years we have treated 526 patients with severe hyperkinetic movement disorders with tetrabenazine(TBZ),a monoamine- depleting and dopamine-receptor-blocking drug.We report here the results in 400 patients with adequate follow-up.The response was rated on a scale of 1 to 5(1=marked improvement,4=no response,5=worsening)and was assessed initially and at the last clinic visit.The average duration of TBZ treatment was 28.9 months(+/-31.1;range,0.25 to 180 months).The global response rating of 1(marked improvement)was recorded in 89.2%of 93 patients with tardive stereotypy,83.3%of 12 with myoclonus,82.8%of 29 with Huntington's disease,80.5%of 82 with tardive dystonia,79.3%of 29 with other movement disorders,62.9%of 108 with idiopathic dystonia,and in 57.4% of 47 with Tourette's syndrome.The most common side effects included drowsiness(36.5%),parkinsonism(28.5%),depression(15.0%),insomnia(11.0%), nervousness or anxiety(10.3%),and akathisia(9.5%).The side effects were controlled with reduction in the dosage.TBZ is an effective and safe drug for the treatment of a variety of hyperkinetic movement disorders.In contrast to typical neuroleptics,TBZ has not been demonstrated to cause tardive dyskinesia. |
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