Antipsychotic Doses in Patients With Tardive Dyskinesia Who Received Valbenazine

BACKGROUND: Valbenazine is indicated for tardive dyskinesia, a movement disorder associated with long-term antipsychotic treatment. This study aimed to clarify changes in real-world antipsychotic prescribing patterns before and after valbenazine initiation. METHODS: This retrospective observational study used real-world claims data of patients with a valbenazine prescription extracted from the Medical Data Vision (MDV) and JMDC databases. The pre-valbenazine period was 183 days before the initiation date, defined as the first valbenazine prescription. The main outcome was antipsychotic drug use by dose, type, and drug class within the pre-valbenazine period and after the valbenazine initiation date. Data in the pre-valbenazine period were compared between the latest date (latest date of antipsychotic prescription before the initiation date) and the earliest date (date of the first antipsychotic prescription within the pre-valbenazine period). RESULTS: The primary analysis included 225 and 141 patients from MDV and JMDC, respectively. During the pre-valbenazine period, the mean difference in chlorpromazine-equivalent doses of antipsychotic medication was +12.4 mg/day and +1.2 mg/day for patients in MDV and JMDC, respectively; there were no clear differences in the mean dose or number and types of antipsychotic drugs between dates. From the latest date to 90 days after the initiation date, the mean difference in antipsychotic dose was -38.3 mg/day and -57.6 mg/day in MDV and JMDC, respectively (∼10% decrease). CONCLUSIONS: Real-world data clarified antipsychotic dosing around valbenazine initiation. Within the 6-month period before valbenazine initiation, antipsychotic doses were stable. Subsequently, minimal changes in antipsychotic dosing were observed after starting valbenazine treatment.