Tardive Dyskinesia - Ingrezza

Tardive Dyskinesia complicates treatment with atypical antipsychotic drugs including Abilify, Risperdal, Zyprexa, Seroquel, Vraylar and Latuda. While the incidence may be slightly less than with the original antipsychotics: Haldol, Stelazine, Serentil, Prolixin, Navane and Trilafon; both classes place individuals at significant risk.
An estimated 500,000 individuals may already experience tardive dyskinesia. Manifestations range from subtle, almost imperceptible, involuntary movements of the lips, mouth, tongue or the area around the forehead and eye to more obvious, repetitive and distracting changes. Some estimates suggest after 1 year of therapy with antipsychotics the incidence approximates 5% with the incidence rising to 25% after 5 years of therapy. Discontinuing therapy seldom relieves the burden which tends to persist indefinitely.
Antipsychotics remain a primary treatment for schizophrenia and increasingly for mania associated with bipolar disorder. Unfortunately this class of drugs seems increasingly prescribed for indications lacking FDA approval and for which many safer therapies exist.
Until Ingrezza received FDA authorization for treatment of Tardive Dyskinesia, no other licensed pharmaceutical was available specifically for this purpose. Treatment begins at a dose of 40 mg once daily and after a week continues at 80 mg daily. Studies presented to the FDA demonstrated a moderate but rarely dramatic improvement in symptoms. Patients seldom benefit by total resolution of their involuntary movements with 1 in 4 showing no change or worsening of the condition. Additionally the lower dose does not appear to be superior compared to an inactive placebo.
Side effects include somnolence, fatigue, sedation and falls related to balance disorders. During an almost 1 year study 1 in 6 participants discontinued the drug as a consequence of adverse reactions. Even for a drug only approved in 2017, the FDA Adverse Event Reporting System has received notice of 116 deaths among individuals receiving Ingrezza. These events do not necessarily represent a cause and effect relationship but fewer than 10% of all complications of therapy are included in the database.
On review of the drug the non-profit rating agency, the Institute for Clinical and Economic Review, suggests the company needs to reduce the wholesale acquisition cost by 85-90% to bring it in line with reality. At present the daily cash price of Ingrezza according to goodrx.com exceeds $260 a day for an average yearly cost above $82,000.
And all this as the result of our excessive use of relatively inexpensive antipsychotics for which safer alternatives often exist.

[@melissacunningham4684]

I got TD, dystonia and akathesia from only 4 months of low dose (50-10mg) seroquel use. These are extremely dangerous drugs. Please do not use them for off label purposes (insomnia/anxiety). Only use for bi-Polar/schizophrenia…. And then proceed with caution.

[@cannygranny1119]

Ingrezza actually worsens TD. It causes the same damage. It also causes severe anxiety depression, and insomnia. Akathisia is also a common side effect and that can be fatal. Using drugs to treat a drug induced issue is like treating burns with fire. They very definition of insanity.

[@taghreedrulia5168]

Very true!

[@nivoonairam8950]

Why hasn't there been class action law suit then?

[@markheithorn3905]

I wonder what the long term side effects are going to be for ingreeza. Will a new drug come out to combat those side effects 🤔

[@andrewmediterranean2560]

More new better tardive dyskinesia medicines will follow ingrezza ,it’s a natural progression but I still think it’s better than no treatment in relation to ingrezza

[@XenoTravis]

A new drug came out but don't take it but it might help but could make it worse

[@777timsmith]

Great video I have tardive dyskinesia for six years from the drug Latuda... I get Botox and I take 80 mg of Ingrezza

[@Billypharding]

Hi Tim do you find ingrezza and Botox helpful. I am having problems with this disorder and my jaw has become misaligned it’s awful!

[@777timsmith]

@@Billypharding Yes my jaw is misaligned and I've also shipped teeth. The Botox helps with the big movements the ingressa helps with the smaller movements but if I'm stressed nothing really helps me keeping a stress-free life is very important. I hope this helps you

[@stupidfish2]

I don't have dystonia anymore. had eye and throat dystonia on olanzapine/risperidone/abilify... But after so many different neuroleptics i am now free from dystonia since about 16 years. even with clozapine my brain had dystonia (eye/throat)! but with seroquel i have absolutely no dystonia!!!! since 16 years no suffering with dystonia thanks to Seroquel. if your so sensitive to Haloperidol/Risperidone/Olanzapine/Abilify, maby its better to reduce dose even if your schizophrenic!

[@no-vaseline7467]

Great video, thank you!

[@omidmehdi]

I got TD from risperidone and orap

[@JAv2305]

What about duetrobenazine ?

[@FayGraceRay]

Please advice me: daughter has been on 6mg Invega for six weeks for trauma-induced psychosis and sleep deprivation. She is going to be coming off this drug. We are looking at tapering, but it is difficult to taper extended release; she also could switch to Risperadal for a proper taper. To discontinue with slow taper, she would be on Invega for months and months more. This, versus a quick discontinuation, where she might have less risk of long-term TD and/or psychosis sensitivity (this is what I have read in a study: takes at least three months for possibility of permanent damage). Please please please advise best course of action. Am I wrong to think there is less risk taking her off quickly than doing a slow taper? Desperate for advice, researching everywhere, but don’t know what to do.

[@greggl.friedmanmd7512]

Great Video on Ingrezza. Ingrezza is FDA approved for the treatment of Tardive Dyskinesia. By Gregg L. Friedman MD