DEUTETRABENAZINE TAB,SA,24HR (EXTENDED RELEASE)
Clinical Criteria Summary
Exclusion Criteria
- Actively suicidal or has untreated or inadequately treated depression
- Congenital long QT interval, or a QTc >450 ms for men or QTc >470 ms for women
- History of cardiac arrhythmias (ventricular), cardiac conduction system disease (LBBB or RBBB), or cardiac device (can be considered candidates with cardiology evaluation)
- Concurrent use of a monoamine oxidase inhibitor (MAOI) or within 14 days of discontinuing therapy with an MAOI
- Current or use of reserpine within the past 20 days
- Concurrent use of another VMAT2 inhibitor (i.e., tetrabenazine, valbenazine)
- History of neuroleptic malignant syndrome (NMS)
- Current clinically significant hyperprolactinemia
- Pregnant or lactating
- Hepatic impairment
Inclusion Criteria: Treatment of Huntington Disease
- Initial prescriber is a resident, fellow, or other trainee: an attending psychiatrist or neurologist has verified the diagnosis and need for deutetrabenazine
- Diagnosis of Huntington disease documented in the medical record
- Chorea is disabling or painful and interferes with functional status (including self-care and ambulation), quality of life, or creates a social stigma sufficient to cause social isolation or embarrassment
- Prescriber has documented specific movement(s) (e.g., facial, oral, extremity, or trunk) in the medical record along with how the chorea is affecting function, quality of life, or socialization
Inclusion Criteria: Treatment of Dystonia
- Initial prescriber is a resident, fellow, or other trainee: an attending psychiatrist or neurologist has verified the diagnosis and need for deutetrabenazine
- No response or intolerant to alternative agents (local botulinum toxin injections, anticholinergics, or benzodiazepines)
Inclusion Criteria: Treatment of Tardive Dyskinesia
- Diagnosis of tardive dyskinesia (TD) secondary to a dopaminergic blocking agent (e.g., antipsychotic or metoclopramide)
- TD interferes with functional status (including self-care and ambulation), quality of life, or creates a social stigma sufficient to cause social isolation or embarrassment
- Prescriber has documented specific movement(s) (e.g., facial, oral, extremity, or trunk) in the medical record along with how TD is affecting function, quality of life, or socialization
- Recent Abnormal Involuntary Movement Scale (AIMS) score is recorded in the medical record
- ECG performed to confirm a QTc <450 ms for men or QTc <470 ms for women
- Initial prescriber is a resident, fellow, or other trainee: an attending psychiatrist or neurologist has verified the diagnosis and need for deutetrabenazine