Tardive Dyskinesia is More Common Than People Realize

"Tardive Dyskinesia is one of those conditions, which is more common than I think most people realize — it affects more than 500,000 people in the United States,” Chris O’Brien, MD, Chief Medical Officer, Neurocrine Sciences, Inc. explained at AAN 2017.

The challenge is the involuntary movements affecting the mouth, tongue, jaw, limbs, and trunk. They add to the stigma of mental illness, which often leads to social isolation. Other people are very uncomfortable near individuals who are already dealing with depression, bipolar disorder, and schizophrenia.

The involuntary movements sometimes cause physical disability like biting the tongue and falling, so treatment of tardive dyskinesia can improve the impact of the condition on these very complicated patients.

O’Brien believes that two groups of doctors will be using Ingrezza: neurologists and psychiatrists. The psychiatrists are the ones treating the patients with underlying psychiatric disease on a day-to-day basis, and they would simply have the option of adding this medication to the program. Neurologists typically get referred the complicated patients with the very unusual movement disorders and discern whether this is really tardive dyskinesia or another neurologic condition, and suggest how Ingrezza could be used.

According to O’Brien, his team knew more than a decade ago that targeting the protein in the brain called VMAT2 could help regulate the dysfunctional movement control system in the basal ganglia. As a result, their first few years of research was devoted to going through molecules to find the one that became valbenazine (Ingrezza). There were many hurdles; the clinical trials for tardive dyskinesia had previously never been done to get a drug approved, so they had to understand how to design and run the trials. “We had setbacks not pushbacks,” O’Brien said.