Valbenazine: A Modern Solution for Tardive Dyskinesia

Tardive dyskinesia (TD) used to be the shadow that followed long-term psychiatric treatment. Even when patients improved, involuntary movements could remain—persistent, embarrassing, and difficult to treat.

Valbenazine changed that story.

This medicine represents a modern, targeted approach that respects neurobiology rather than forcing it. It works quietly, precisely, and allows many patients to reclaim confidence in their bodies.

What Is Valbenazine?

Valbenazine is a VMAT2 inhibitor—a medication that regulates how dopamine is packaged and released in the brain.

VMAT2 (vesicular monoamine transporter 2) acts like a conveyor belt that moves dopamine into tiny storage vesicles. When VMAT2 runs too fast, dopamine signalling becomes chaotic, which contributes to TD.

Valbenazine slows this down just enough to restore balance.

It doesn’t block receptors. It doesn’t sedate. It modulates.

Why Tardive Dyskinesia Happens

Long-term exposure to antipsychotics or certain other dopamine-blocking medications can make the dopamine system hypersensitive.
This leads to:

  • Facial grimacing

  • Tongue movements

  • Lip smacking

  • Jaw movements

  • Finger/limb movements

TD can affect self-esteem, employability, and social interactions—even when the underlying psychiatric condition is well-controlled.

Valbenazine gives us a targeted treatment for this specific vulnerability.

How Valbenazine Works

The brilliance is in its subtlety.

Valbenazine reduces the amount of dopamine released into the synapse without shutting down normal motor function.
Because it modulates rather than blocks:

  • Movements improve gradually

  • Patients stay alert and functional

  • Underlying psychiatric stability remains intact

For many, symptoms reduce within 2–6 weeks and continue improving with long-term use.

Clinical Trial Evidence

Multiple phase III trials (KINECT studies) demonstrate that Valbenazine:

  • Significantly reduces TD scores (AIMS)

  • Improves quality of life

  • Works across diagnoses (schizophrenia, bipolar disorder, mood disorders)

  • Has durable benefits with long-term use

  • Is safe, non-sedating, and well tolerated

Patients often describe a sense of “quieting” in their face and body—movements that once felt autonomous become controllable again.

Side Effects: What to Expect

Valbenazine is generally well tolerated. Possible effects include:

  • Sleepiness

  • Dry mouth

  • Headache

  • Mild QTc prolongation (rarely problematic)

Critically, it doesn’t worsen psychiatric symptoms, which makes it safe to pair with antipsychotics when necessary.

Why Valbenazine Matters in Today’s Psychiatry

Modern psychiatric care isn’t just about treating illness; it’s about preserving dignity.
TD can make people avoid eye contact, skip social events, or feel self-conscious in public.

A medicine like Valbenazine:

  • Restores normalcy

  • Improves social comfort

  • Lets patients continue psychiatric treatment without fear

  • Reinforces trust in the therapeutic process

For clinicians and families, it’s a tool that closes the gap between mental stability and physical ease.

Who Should Consider Valbenazine?

Anyone experiencing:

  • Persistent involuntary movements after antipsychotic use

  • Facial or oral movements that cause embarrassment

  • Limb movements that interfere with function

  • TD symptoms despite stopping or switching medications

Early identification and treatment prevent long-term complications.

About the Author

Dr. Srinivas Rajkumar T, MD (AIIMS), DNB, MBA (BITS Pilani)
Consultant Psychiatrist & Neurofeedback Specialist
Mind & Memory Clinic, Apollo Clinic Velachery (Opp. Phoenix Mall)
srinivasaiims@gmail.com 📞 +91-8595155808

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