Understanding Austedo and Ingrezza for Tardive Dyskinesia: Uses, Mechanisms, and Side Effects in Adults

What Is Tardive Dyskinesia and How Do Austedo and Ingrezza Affect Involuntary Movements?

Tardive dyskinesia involves involuntary, repetitive movements such as lip smacking, tongue movements, blinking, or twitching that commonly affect the face, torso, and limbs. These symptoms are often linked to long-term use of dopamine receptor-blocking agents like antipsychotics.

Austedo and Ingrezza work by targeting neurochemical pathways involved in TD:

• Both medications are VMAT2 inhibitors (vesicular monoamine transporter 2). VMAT2 regulates the transport of neurotransmitters such as dopamine in nerve cells.
• By inhibiting VMAT2, these drugs aim to reduce dopamine release in brain regions that control movement, which may help decrease involuntary movements.
• Both are also approved for treating chorea associated with Huntington’s disease.

How Austedo Works

Austedo contains deutetrabenazine, which reversibly inhibits VMAT2 to reduce excessive dopamine signaling linked to abnormal movements in tardive dyskinesia.

• It is taken orally, typically once or twice daily with food.
• An extended-release form (Austedo XR) is also available to simplify dosing.
• Austedo tablets should be stored in a cool, dry place away from moisture and light.

How Ingrezza Works

Ingrezza contains valbenazine and selectively inhibits VMAT2 without significant interaction with other neurotransmitter receptors.

• It is taken once daily, available in capsule and “sprinkle” formulations (for patients with difficulty swallowing pills).
• Ingrezza dosing starts at therapeutic levels without the need for titration.
• Its action reduces dopamine release, which may help control involuntary movements in TD.

Reported Results from Studies on Ingrezza for Tardive Dyskinesia

Data from a 48-week open-label Phase 3 study called KINECT 4 reported:

• Many adults treated daily with Ingrezza experienced reduction in TD symptoms, including minimal or no abnormal involuntary movements as evaluated by certain clinical scales.
• Improvements were reported across patients with different underlying psychiatric conditions such as schizophrenia, schizoaffective disorder, or mood disorders.
• Both studied doses (40 mg and 80 mg) demonstrated symptom reductions over the study period.

These findings support the role of Ingrezza as a treatment option for managing symptoms of TD in adults.

Side Effects of Austedo and Ingrezza in Adults with Tardive Dyskinesia

Both medications include safety warnings related to the risk of depression and suicidal thoughts or behaviors, particularly in Huntington’s disease patients. Patients should be monitored closely by healthcare providers.

Common Side Effects of Austedo

• Sleepiness and fatigue
• Diarrhea
• Urinary tract infections (UTIs)
• Bruising
• Restlessness (akathisia)
• Movement-related symptoms such as slowed movements, muscle stiffness, or balance issues
• Elevated blood prolactin levels, which may have effects on fertility or bone health

Serious Risks with Austedo

• Allergic reactions, which may be severe
• Suicidal ideation or behavior (requires monitoring)
• Heart rhythm changes (QT prolongation), especially in patients with risk factors such as electrolyte imbalances or cardiac history
• Neuroleptic malignant syndrome (NMS), a rare but serious condition

Patients are advised to avoid driving or operating heavy machinery until they understand how Austedo affects their alertness.

Common Side Effects of Ingrezza

• Sleepiness and tiredness
• Dizziness
• Blurred vision
• Headache
• Rash
• Urinary retention

Serious Risks with Ingrezza

• Depression and suicidal thoughts (boxed warning applies)
• Parkinsonism symptoms that may appear within weeks or dose changes, including tremor, muscle rigidity, or slow movements
• Rare reports of neuroleptic malignant syndrome (post-marketing)

Side Effect Profiles: How Austedo and Ingrezza Compare

• Both medications may cause sleepiness, depression, and suicidal thoughts, and share rare but serious risks including NMS.
• Austedo may more commonly cause diarrhea, urinary tract infections, and bruising.
• Ingrezza may more frequently cause blurred vision and urinary retention.

Choosing between the two depends on individual medical history, side effect tolerance, and physician guidance.

Additional Information Regarding Movement Issues and Related Medications

• The antipsychotic Abilify (aripiprazole) has been associated with various movement disorders, including tardive dyskinesia or twitching, though treatment of these symptoms requires evaluation by a healthcare provider and may not involve Austedo or Ingrezza.
• Clonazepam is not FDA-approved for treating tardive dyskinesia.
• Levodopa is used for certain movement disorders but is not indicated for treating tardive dyskinesia with Austedo or Ingrezza.
• Educational materials illustrating tardive dyskinesia symptoms such as lip smacking are available through specialist movement disorder resources.

Important Patient Considerations and Guidance

• Austedo and Ingrezza should be used only under medical supervision with regular monitoring for changes in mood, heart function, and movement symptoms.
• Patients should inform healthcare providers about all current medications and supplements to minimize drug interactions, particularly those affecting heart rhythm or liver metabolism.
• Alcohol use may increase drowsiness risk with Austedo.
• These drugs are not recommended for patients with significant liver impairment without appropriate evaluation and monitoring.
• Patients and caregivers are encouraged to promptly report symptoms such as allergic reactions, mood changes, suicidal thoughts, or new or worsening movement problems to their healthcare provider.

As of 2025, Austedo and Ingrezza are FDA-approved oral treatment options for adult patients diagnosed with tardive dyskinesia in the United States. Both medications work as VMAT2 inhibitors to reduce dopamine signaling associated with involuntary movements.

Both drugs carry potential side effects, including common ones like sleepiness and rare but serious risks such as suicide risk and heart rhythm changes. Ingrezza has data from clinical studies demonstrating symptom reductions over time in many patients.

Selecting the most appropriate treatment involves individualized assessment by healthcare providers considering potential benefits, side effect profiles, and patient preferences.

Ongoing communication with healthcare professionals is important for safe use, monitoring effects, and managing tardive dyskinesia symptoms.

Sources

• Healthline: Side Effects of Ingrezza
• WebMD: Austedo (deutetrabenazine)
• PR Newswire: Neurocrine Biosciences Presents 48-Week Data on Ingrezza

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