Why INGREZZA?

Mechanism of tardive dyskinesia1-4

Hyperactive D2 signaling

While the mechanism of TD is not fully understood, it is believed that:

  • 1

    TD is associated with prolonged exposure to dopamine receptor blocking agents (DRBAs), including antipsychotics, which may result in hyperactive dopamine signaling1,2

  • 2

    This is believed to cause hypersensitivity in postsynaptic dopamine D2 receptors in one of the areas of the brain that controls motor function1,2

1 2 INGREZZA™ (valbenazine) VMAT2 dopamine signaling

INGREZZA mechanism of action4

INGREZZA selectively inhibits VMAT24

While the MOA is not fully understood, it is believed that:

  • 1

    It may be mediated through selective inhibition of VMAT2 in presynaptic neurons4

  • 2

    INGREZZA provides reversible reductions of dopamine release into the synaptic cleft4

  • 3

    INGREZZA reduces the amount of dopamine available to hypersensitive postsynaptic dopamine D2 receptors1,4

1 2 3 INGREZZA™ (valbenazine) VMAT2 inhibiting Watch the full INGREZZA MOA

Assess patients for tardive dyskinesia

The examples below may be similar to patients in your practice

Review the case study examples of patients and assess if they may have tardive dyskinesia (TD).

Be sure to look for5:

  • History and current use of dopamine receptor blocking agents (DRBAs), including first-generation and second-generation antipsychotics

  • Choreiform (rapid and jerky) movements of the eyes, lips, jaw, tongue, and limbs

  • Athetoid (slow, sinuous, or writhing) movements of the hands, feet, and trunk

  • Paul L

    53 years old with bipolar disorder

  • Diana J

    32 years old with schizophrenia

  • Ashley Q

    56 years old with schizoaffective disorder and anxiety disorder

  • Stanley H

    48 years old with history of major depression

Meet Paul L

a 53-year-old male with bipolar disorder

  • Paul’s bipolar disorder is currently stable since adding olanzapine, a second-generation antipsychotic, to his treatment regimen 11 months ago
  • Paul’s wife, who helps coordinate his care, has noticed him exhibiting persistent, repetitive eye blinking
  • She has also recently noticed repetitive hand movements and trunk swaying
  • Others have also mentioned Paul’s movements

Might Paul have TD?

YES

NO

Paul may have TD.

Although his bipolar disorder is stable after adding a new second-generation antipsychotic to his treatment regimen, he has developed involuntary movements. They appear to be choreiform movements of the eyes and athetoid movements of the hands and trunk.

Next: Assess Diana J

Meet Diana J

a 32-year-old female with schizophrenia

  • Diana has been hospitalized several times in the last 2 years and has cycled through multiple first-generation and second-generation antipsychotics
  • She has achieved psychiatric stability on her current treatment regimen, but has recently developed jaw distension, lip puckering, and some writhing movements in her hands
  • Diana has struggled to find and maintain employment and is currently living in a group home environment

Might Diana have TD?

YES

NO

Diana may have TD.

Over the past 2 years, she has taken multiple DRBAs (ie, first-generation and second-generation antipsychotics). Despite achieving stability in her schizophrenia on her current DRBA, Diana is exhibiting choreiform movements of her jaw and lips, as well as athetoid movements in her hands.

Next: Assess Ashley Q

Meet Ashley Q

a 56-year-old female with schizoaffective disorder and anxiety disorder

  • Ashley currently works part-time from her home since her condition stabilized over a year ago, when she was switched from a first-generation antipsychotic to aripiprazole, a second-generation antipsychotic
  • Before her condition stabilized, Ashley was also diagnosed with an anxiety disorder, for which she was prescribed a benzodiazepine (bid)
  • Recently, she has developed chronic jaw distention and grimacing, which have increased in frequency and severity
  • Ashley has expressed embarrassment due to her condition

Might Ashley have TD?

YES

NO

Ashley may have TD.

She is exhibiting signs of TD, such as choreiform movements in her jaw and mouth. Switching to a new second-generation antipsychotic helped stabilize her schizoaffective disorder, but her TD signs show no improvement.

Next: Assess Stanley H

Meet Stanley H

a 48-year-old male with history of major depression

  • Stanley adjunctively started quetiapine, a first-generation antipsychotic, 6 months ago
  • He has recently developed involuntary tongue protrusion and lip smacking
  • He has experienced these movements during several meetings at work
  • Friends/colleagues at work have commented on these movements

Might Stanley have TD?

YES

NO

Stanley may have TD.

Despite a relatively short period of time on a first-generation antipsychotic, he has developed choreiform movements in his tongue and lips. These movements have worsened and become noticeable to his friends and colleagues.

Not an actual patient
  • Meet Paul L

    a 53-year-old male with bipolar disorder

    Assess Paul
    • Paul’s bipolar disorder is currently stable since adding olanzapine, a second-generation antipsychotic, to his treatment regimen 11 months ago
    • Paul’s wife, who helps coordinate his care, has noticed him exhibiting persistent, repetitive eye blinking
    • She has also recently noticed repetitive hand movements and trunk swaying
    • Others have also mentioned Paul’s movements

    Might Paul have TD?

    YES

    NO

    Paul may have TD.

    Although his bipolar disorder is stable after adding a new second-generation antipsychotic to his treatment regimen, he has developed involuntary movements. They appear to be choreiform movements of the eyes and athetoid movements of the hands and trunk.

    Next: Assess Diana J

    Not an actual patient
  • Meet Diana J

    a 32-year-old female with schizophrenia

    Assess Diana
    • Diana has been hospitalized several times in the last 2 years and has cycled through multiple first-generation and second-generation antipsychotics
    • She has achieved psychiatric stability on her current treatment regimen, but has recently developed jaw distension, lip puckering, and some writhing movements in her hands
    • Diana has struggled to find and maintain employment and is currently living in a group home environment

    Might Diana have TD?

    YES

    NO

    Diana may have TD.

    Over the past 2 years, she has taken multiple DRBAs (ie, first-generation and second-generation antipsychotics). Despite achieving stability in her schizophrenia on her current DRBA, Diana is exhibiting choreiform movements of her jaw and lips, as well as athetoid movements in her hands.

    Next: Assess Ashley Q

    Not an actual patient
  • Meet Ashley Q

    a 56-year-old female with schizoaffective disorder and anxiety disorder

    Assess Ashley
    • Ashley currently works part-time from her home since her condition stabilized over a year ago, when she was switched from a first-generation antipsychotic to aripiprazole, a second-generation antipsychotic
    • Before her condition stabilized, Ashley was also diagnosed with an anxiety disorder, for which she was prescribed a benzodiazepine (bid)
    • Recently, she has developed chronic jaw distention and grimacing, which have increased in frequency and severity
    • Ashley has expressed embarrassment due to her condition

    Might Ashley have TD?

    YES

    NO

    Ashley may have TD.

    She is exhibiting signs of TD, such as choreiform movements in her jaw and mouth. Switching to a new DRBA (ie, second-generation antipsychotic) helped stabilize her schizoaffective disorder, but her TD signs show no improvement.

    Next: Assess Stanley H

    Not an actual patient
  • Meet Stanley H

    a 48-year-old male with history of major depression

    Assess Stanley
    • Stanley adjunctively started quetiapine, a first-generation antipsychotic, 6 months ago
    • He has recently developed involuntary tongue protrusion and lip smacking
    • He has experienced these movements during several meetings at work
    • Friends/colleagues at work have commented on these movements

    Might Stanley have TD?

    YES

    NO

    Stanley may have TD.

    Despite a relatively short period of time on a DRBA (ie, first-generation antipsychotic), he has developed choreiform movements in his tongue and lips. These movements have worsened and become noticeable to his friends and colleagues.

    Not an actual patient
Not actual patients
  • Mechanism of TD/Mechanism of action

    Mechanism of tardive dyskinesia1-4

    Hyperactive D2 signaling

    While the mechanism of TD is not fully understood, it is believed that:

    • 1

      TD is associated with prolonged exposure to dopamine receptor blocking agents (DRBAs), including antipsychotics, which may result in hyperactive dopamine signaling1,2

    • 2

      This is believed to cause hypersensitivity in postsynaptic dopamine D2 receptors in one of the areas of the brain that controls motor function1,2

    1 2 INGREZZA™ (valbenazine) VMAT2 dopamine signaling

    INGREZZA mechanism of action4

    INGREZZA selectively inhibits VMAT24

    While the MOA is not fully understood, it is believed that:

    • 1

      It may be mediated through selective inhibition of VMAT2 in presynaptic neurons4

    • 2

      INGREZZA provides reversible reductions of dopamine release into the synaptic cleft4

    • 3

      INGREZZA reduces the amount of dopamine available to hypersensitive postsynaptic dopamine D2 receptors1,4

    1 2 3 INGREZZA™ (valbenazine) VMAT2 inhibiting Watch the full INGREZZA MOA
  • Assess patients for TD

    Assess patients for tardive dyskinesia

    The examples below may be similar to patients in your practice

    Review the case study examples of patients and assess if they may have tardive dyskinesia (TD).

    Be sure to look for5:

    • History and current use of dopamine receptor blocking agents (DRBAs), including first-generation and second-generation antipsychotics

    • Choreiform (rapid and jerky) movements of the eyes, lips, jaw, tongue, and limbs

    • Athetoid (slow, sinuous, or writhing) movements of the hands, feet, and trunk

    • Paul L

      53 years old with bipolar disorder

    • Diana J

      32 years old with schizophrenia

    • Ashley Q

      56 years old with schizoaffective disorder and anxiety disorder

    • Stanley H

      48 years old with history of major depression

    Meet Paul L

    a 53-year-old male with bipolar disorder

    • Paul’s bipolar disorder is currently stable since adding olanzapine, a second-generation antipsychotic, to his treatment regimen 11 months ago
    • Paul’s wife, who helps coordinate his care, has noticed him exhibiting persistent, repetitive eye blinking
    • She has also recently noticed repetitive hand movements and trunk swaying
    • Others have also mentioned Paul’s movements

    Might Paul have TD?

    YES

    NO

    Paul may have TD.

    Although his bipolar disorder is stable after adding a new second-generation antipsychotic to his treatment regimen, he has developed involuntary movements. They appear to be choreiform movements of the eyes and athetoid movements of the hands and trunk.

    Next: Assess Diana J

    Meet Diana J

    a 32-year-old female with schizophrenia

    • Diana has been hospitalized several times in the last 2 years and has cycled through multiple first-generation and second-generation antipsychotics
    • She has achieved psychiatric stability on her current treatment regimen, but has recently developed jaw distension, lip puckering, and some writhing movements in her hands
    • Diana has struggled to find and maintain employment and is currently living in a group home environment

    Might Diana have TD?

    YES

    NO

    Diana may have TD.

    Over the past 2 years, she has taken multiple DRBAs (ie, first-generation and second-generation antipsychotics). Despite achieving stability in her schizophrenia on her current DRBA, Diana is exhibiting choreiform movements of her jaw and lips, as well as athetoid movements in her hands.

    Next: Assess Ashley Q

    Meet Ashley Q

    a 56-year-old female with schizoaffective disorder and anxiety disorder

    • Ashley currently works part-time from her home since her condition stabilized over a year ago, when she was switched from a first-generation antipsychotic to aripiprazole, a second-generation antipsychotic
    • Before her condition stabilized, Ashley was also diagnosed with an anxiety disorder, for which she was prescribed a benzodiazepine (bid)
    • Recently, she has developed chronic jaw distention and grimacing, which have increased in frequency and severity
    • Ashley has expressed embarrassment due to her condition

    Might Ashley have TD?

    YES

    NO

    Ashley may have TD.

    She is exhibiting signs of TD, such as choreiform movements in her jaw and mouth. Switching to a new second-generation antipsychotic helped stabilize her schizoaffective disorder, but her TD signs show no improvement.

    Next: Assess Stanley H

    Meet Stanley H

    a 48-year-old male with history of major depression

    • Stanley adjunctively started quetiapine, a first-generation antipsychotic, 6 months ago
    • He has recently developed involuntary tongue protrusion and lip smacking
    • He has experienced these movements during several meetings at work
    • Friends/colleagues at work have commented on these movements

    Might Stanley have TD?

    YES

    NO

    Stanley may have TD.

    Despite a relatively short period of time on a first-generation antipsychotic, he has developed choreiform movements in his tongue and lips. These movements have worsened and become noticeable to his friends and colleagues.

    Not an actual patient
    • Meet Paul L

      a 53-year-old male with bipolar disorder

      Assess Paul
      • Paul’s bipolar disorder is currently stable since adding olanzapine, a second-generation antipsychotic, to his treatment regimen 11 months ago
      • Paul’s wife, who helps coordinate his care, has noticed him exhibiting persistent, repetitive eye blinking
      • She has also recently noticed repetitive hand movements and trunk swaying
      • Others have also mentioned Paul’s movements

      Might Paul have TD?

      YES

      NO

      Paul may have TD.

      Although his bipolar disorder is stable after adding a new second-generation antipsychotic to his treatment regimen, he has developed involuntary movements. They appear to be choreiform movements of the eyes and athetoid movements of the hands and trunk.

      Next: Assess Diana J

      Not an actual patient
    • Meet Diana J

      a 32-year-old female with schizophrenia

      Assess Diana
      • Diana has been hospitalized several times in the last 2 years and has cycled through multiple first-generation and second-generation antipsychotics
      • She has achieved psychiatric stability on her current treatment regimen, but has recently developed jaw distension, lip puckering, and some writhing movements in her hands
      • Diana has struggled to find and maintain employment and is currently living in a group home environment

      Might Diana have TD?

      YES

      NO

      Diana may have TD.

      Over the past 2 years, she has taken multiple DRBAs (ie, first-generation and second-generation antipsychotics). Despite achieving stability in her schizophrenia on her current DRBA, Diana is exhibiting choreiform movements of her jaw and lips, as well as athetoid movements in her hands.

      Next: Assess Ashley Q

      Not an actual patient
    • Meet Ashley Q

      a 56-year-old female with schizoaffective disorder and anxiety disorder

      Assess Ashley
      • Ashley currently works part-time from her home since her condition stabilized over a year ago, when she was switched from a first-generation antipsychotic to aripiprazole, a second-generation antipsychotic
      • Before her condition stabilized, Ashley was also diagnosed with an anxiety disorder, for which she was prescribed a benzodiazepine (bid)
      • Recently, she has developed chronic jaw distention and grimacing, which have increased in frequency and severity
      • Ashley has expressed embarrassment due to her condition

      Might Ashley have TD?

      YES

      NO

      Ashley may have TD.

      She is exhibiting signs of TD, such as choreiform movements in her jaw and mouth. Switching to a new DRBA (ie, second-generation antipsychotic) helped stabilize her schizoaffective disorder, but her TD signs show no improvement.

      Next: Assess Stanley H

      Not an actual patient
    • Meet Stanley H

      a 48-year-old male with history of major depression

      Assess Stanley
      • Stanley adjunctively started quetiapine, a first-generation antipsychotic, 6 months ago
      • He has recently developed involuntary tongue protrusion and lip smacking
      • He has experienced these movements during several meetings at work
      • Friends/colleagues at work have commented on these movements

      Might Stanley have TD?

      YES

      NO

      Stanley may have TD.

      Despite a relatively short period of time on a DRBA (ie, first-generation antipsychotic), he has developed choreiform movements in his tongue and lips. These movements have worsened and become noticeable to his friends and colleagues.

      Not an actual patient
    Not actual patients