Tetrabenazine is a medication available for the treatment of chorea, uncontrolled and disorganized movements associated with Huntington's disease, among other health conditions. Chorea can cause repetitive twisting, twitching, and flexing movements and may make it difficult for patients to work and engage in other activities. This drug does not cure chorea or Huntington's, but will increase patient comfort by reducing the frequency of unwanted and involuntary movements. It is available by prescription only.
The drug acts to deplete monoamines, a class of neurotransmitters that includes dopamine. Dopamine plays a key role in the development of chorea, as when levels start to rise, it can easily transmit electrical signals to the muscles, causing contractions. Patients taking tetrabenazine will break down dopamine more quickly, rather than allowing it to linger in the body, reducing the amount of involuntary movements. The drug's effects are reversible; as soon as patients stop taking it, their dopamine depletion rate will return to normal.
Patients on tetrabenazine can experience side effects like pacing, dizziness, and depression. The risk of depression and suicidal thoughts is especially high in patients with a history of these problems, and a doctor may decide not to prescribe the drug for such patients. It can also interact negatively with other drugs, including medications a doctor may prescribe to treat depression, and it is important to discuss this when preparing to take tetrabenazine, to determine if anything in a patient's history or current drug regimen is a risk.
In addition to being useful for treating Huntington's chorea, this drug can also provide relief for patients with tardive dyskinesia and conditions that cause muscular tics like facial twitching. A doctor can review a patient's case to determine if the drug would be suitable and helpful. Patients start on a low dose and titer up until they find an appropriate dosage. The doctor may request regular appointments while a patient adjusts to tetrabenazine to check for any side effects and adjust the dosage as necessary.
This oral medication should be stored in a cool, dry place, out of the reach of children. Patients who start to experience side effects must report them promptly. The doctor can determine if the patient needs a different dosage or if it is necessary to stop taking the medication. Chorea can be frustrating for patients, but serious side effects are potentially dangerous. Stopping the drug because of harmful side effects, even if it is helping with the chorea, is in the best interest of the patient in the long term.