What Condition Does Ingrezza Treat- A Complete Guide

Tardive Dyskinesia or TD is a debilitating, often permanent side-effect of certain medications like anti-psychotics, which work by blocking dopamine. It is characterized by involuntary and repetitive movements of the eyes, tongue, legs, and hands. In a matter of time, patients start finding it difficult to eat or go out because these uncontrolled movements interfere with daily tasks, making it extremely laborious to do simple activities. While limiting the anti-psychotic medicines usage is the first and most crucial step to take, this blog explores Valbenazine, or Ingrezza, a new, innovative, and targeted therapy that can help manage TD. ¹

Let’s take a look at the early and late symptoms of TD:¹

Early Symptoms: The early symptoms of TD include minor involuntary movements.

It all may start with almost unacknowledged movements, such as:

-Uncontrolled facial movements like involuntarily puckering up lips and making sucking motions, lip smacking, tongue movements (thrusting, darting), or grimacing.

-Blinking, or rapid eye movements that become hard to control. (Blepharospasm)

-Changes in the ability to speak fluently.

Late Symptoms:

Late symptoms include severe involuntary movements, which are more pronounced and persistent than the earlier symptoms.

- Facial grimacing, rapid, jerking movements of arms and legs, as well as twisting movements.

- Akathisia or the inability to remain still.

-Patients experience difficulty with daily activities as these movements can interfere with eating, speaking, and moving around.

-All these symptoms have unavoidable psychosocial effects as patients suffer from increased anxiety, embarrassment, or depression due to visible symptoms and deteriorating condition.

Managing Tardive Dyskinesia: What can you do? ^{1, 3}

Watch out: When you or your physician first notice TD symptoms, it is crucial to reduce or cut out the causative medicines and switch to the ones that won't trigger or worsen TD. Regular supervision of TD symptoms is essential.

Multidisciplinary care: Patients may require multidisciplinary care to maintain quality of life. This includes physiotherapy and occupational therapy to simplify daily activities and preserve the physical ability for overall functioning.

Mindful movements: Gentle exercises and practicing mindfulness can help improve motor control, and regular exercise also decreases anxiety, proving to be a beneficial addition to a TD patient’s routine.

Avoiding triggers: Identify and avoid triggers. Stress is a known trigger that tends to worsen uncontrolled movements in TD, and hence, it makes stress management a valuable skill to learn and adapt when dealing with TD.

It is important to remember that while treatments like VMAT2 inhibitors can help, prevention (limiting long-term anti-psychotic/ DRBA use) is critical, along with complete neurological care and physiotherapy, etcetera.

Valbenazine (Ingrezza), a VMA2 Inhibitor- making all the difference

How is Ingrezza, a VMA2 inhibitor, subsiding TD symptoms?²
VMA2 is a protein in our body responsible for storing neurotransmitters (chemical messengers) like dopamine in the synaptic vesicles, which are the terminal part of a nerve cell/ neuron.

It is widely accepted and believed that TD occurs due to increased dopamine in these vesicles and our body’s heightened response to it. Increase in dopamine and sensitivity to it is often a side-effect of some anti-psychotics, which are the leading cause of TD.

Ingrezza’s Targeted mechanism: ²

VMA2 inhibitors like Ingrezza block this VMA2 protein, which prevents dopamine from being stored in the synaptic vesicles.

So, essentially, Ingrezza hits the problem where it starts by blocking the dopamine storage in the neuron, reducing its availability.

Taking Ingrezza: ²

Ingrezza is usually supplied as a capsule that is supposed to be swallowed whole. A healthcare provider assesses the patient's condition and decides on the correct dosage. This dose should be followed as per the healthcare provider’s instructions, and any side effects should be reported.

Side effects:²

Ingrezza is generally well-tolerated. Common side effects include somnolence, tiredness, or lethargy. Compared to older treatments for TD, Ingrezza has a much more favorable side-effect profile. Some of the common side effects include:

-Drowsiness and fatigue.

-Blurred vision, lightheadedness & difficulty in staying attentive.

-Dry mouth. Ingrezza can cause dryness throughout the body, resulting in dry mouth, constipation, and blurry vision. These can be managed upon consulting with the prescribing physician and following medical advice.

-Urinary retention, nausea, vomiting.

-Restlessness

Although serious side effects are uncommon, the following can be possible:²

-Pounding heartbeat

-Seriously blurred vision or vision loss.

-Hives, fever, and swelling of the face.

-High fever

-Tremors, Parkinsonism:

-Neuroleptic Malignant syndrome,

In case of any serious side effects, patients should be taken into emergency care and the Healthcare provider must be consulted as soon as possible.

Other uses of Ingrezza: Ingrezza may also be prescribed by physicians to treat Huntington's disease-related Chorea. Chorea is a movement disorder somewhat similar to TD. Huntington’s is a genetic disorder, and chorea is one of its symptoms. In Huntington’s disease-associated chorea, a patient experiences a similar loss of control over bodily movements as seen in TD. 2

Safety and efficacy: ²
Ingrezza was first approved by the FDA as a TD Medicine in 2017 when Ingrezza reduced Dyskinesia symptoms in half for at least 40% of the participants in Phase III clinical trials. In 2023, it was approved for use in the treatment of Huntington’s disease-related chorea.

It is NOT recommended in pregnancy and lactation. Consult your physician for more information.

Accessing Ingrezza in India:

While approved for treatment by the FDA, Tardive Dyskinesia & Huntington’s disease-associated chorea remain rare and usually underdiagnosed 4 diseases, as a result, medicines like Ingrezza that can change a patient's life are not easily accessible. Rx4u solves this problem by importing such medications and delivering them to your doorstep. Rx4u is a platform dedicated to making life-changing drugs such as Ingrezza available to Indian patients who will benefit from them. If you or someone you know is diagnosed with Tardive Dyskinesia or HD-related chorea, then you can safely import Ingrezza as Rx4u’s global supply network ensures authentic medicines and timely delivery. ⁵

Note:

The information provided is for educational purposes only and is subject to prescribing information of the drug and the guidance of your treating physician. Always consult your healthcare provider before making any medical decision for starting your treatment.

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