To describe symptom impact and treatment outcomes in patients prescribed vesicular monoamine transporter 2 (VMAT2) inhibitors for the treatment of tardive dyskinesia (TD).

Based on clinical studies for two approved VMAT2 inhibitors (valbenazine, deutetrabenazine), these medications are recommended as first-line therapies for TD (Bhidayasiri, J Neurol Sci 2018). Data based on real-world experience with these drugs are now available.

Data for 601 adult TD patients were provided by 163 responding clinicians (113 psychiatrists; 46 neurologists; 4 primary care physicians). 50% of patients were male; mean age was 50.6 years; and most were taking an antipsychotic for schizophrenia (32%), bipolar disorder (29%), schizoaffective disorder (23%), and/or major depressive disorder (11%). Approximately two-thirds of patients had an additional psychiatric comorbidity, including anxiety (33%), depressive symptoms (28%), and substance abuse (18%). TD symptoms were most frequently found in the head/face/mouth region (82%). TD impacts included negative effects on socializing (84%) and engagement with family/friends (77%). TD symptom improvement with a VMAT2 inhibitor was reported in 540 (90%) patients, most of whom also had functional improvements in ≥1 area. Among patients with TD improvement, 374 (69%) had “much” or “significant” improvement in their psychiatric condition.

In this real-world sample of patients, treatment with a VMAT 2 inhibitor improved TD symptoms and TD-related outcomes. These improvements also appeared to be associated with better psychiatric status. Clinicians/payers/professional organizations should consider symptom impact and treatment outcomes when evaluating TD therapies.