WARNING: DEPRESSION AND SUICIDALITY
XENAZINE can increase the risk of depression and suicidal thoughts and behavior (suicidality) in patients with Huntington's disease. Anyone considering the use of XENAZINE must balance the risks of depression and suicidality with the clinical need for control of choreiform movements. Close observation of patients for the emergence or worsening of depression, suicidality, or unusual changes in behavior should accompany therapy. Patients, their caregivers, and families should be informed of the risk of depression and suicidality and should be instructed to report behaviors of concern promptly to the treating physician.
Particular caution should be exercised in treating patients with a history of depression or prior suicide attempts or ideation, which are increased in frequency in Huntington's disease. XENAZINE is contraindicated in patients who are actively suicidal, and in patients with untreated or inadequately treated depression [see
Warnings and Precautions
XENAZINE (tetrabenazine) is a monoamine depletor for oral administration.
XENAZINE is indicated for the treatment of chorea associated with Huntington’s disease.
Published Studies Related to Xenazine (Tetrabenazine)
Tetrabenazine augmentation in treatment-resistant schizophrenia: a 12-week,
double-blind, placebo-controlled trial. 
Evidence linking schizophrenia to alterations in presynaptic dopamine (DA) grows,
although treatments to date have largely focused on postsynaptic D2 receptor
blockade... It may be premature,
however, to discount the potential benefits of VMAT2 inhibitors in treating
psychosis in light of what is presently understood regarding presynaptic DA's
role and evidence that "endogenous sensitization" may occur over the course of
Tetrabenazine as anti-chorea therapy in Huntington disease: an open-label continuation study. Huntington Study Group/TETRA-HD Investigators. [2009.12.18]
BACKGROUND: Tetrabenazine (TBZ) selectively depletes central monoamines by reversibly binding to the type-2 vesicular monoamine transporter. A previous double blind study in Huntington disease (HD) demonstrated that TBZ effectively suppressed chorea, with a favorable short-term safety profile (Neurology 2006;66:366-372). The objective of this study was to assess the long-term safety and effectiveness of TBZ for chorea in HD... CONCLUSIONS: TBZ effectively suppresses HD-related chorea for up to 80 weeks. Patients treated chronically with TBZ should be monitored for parkinsonism, dysphagia and other side effects including sleep disturbance, depression, anxiety, and akathisia. TRIAL REGISTRATION: Clinicaltrials.gov registration number (initial study): NCT00219804.
A study of chorea after tetrabenazine withdrawal in patients with Huntington disease. [2008.05]
OBJECTIVE: To assess tetrabenazine (TBZ) efficacy by evaluating the change in Huntington disease-associated chorea resulting from TBZ treatment withdrawal... CONCLUSIONS: The trend for reemergence of chorea in patients with Huntington disease who were withdrawn from TBZ treatment is consistent with the findings from previous studies, thus showing the effectiveness of TBZ in reducing chorea.
Tetrabenazine for the treatment of tardive dyskinesia. [2011.04]
CONCLUSIONS: Small trials indicate tetrabenazine may be effective for the treatment of tardive dyskinesia. However, larger, well-conducted trials are needed to confirm these findings. Currently, there is a lack of data coupled with the risk of significant adverse effects to recommend the routine use of tetrabenazine in the management of tardive dyskinesia. Before using tetrabenazine for the management of tardive dyskinesia, all other options should be exhausted and careful monitoring employed.
Management of Huntington's disease: role of tetrabenazine. 
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder characterized by progressive involuntary movements, neuropsychiatric disturbances, and cognitive impairment... Despite the fact that the global effect of TBZ seems positive in HD, more attention on evaluating symptomatic treatments for cognitive and psychiatric deterioration as well as motor deterioration would alleviate this devastating disorder until a neuroprotective treatment becomes available.
Clinical Trials Related to Xenazine (Tetrabenazine)
A Pilot Study Assessing Impulsivity in Patients With Huntington's Disease on Xenazine (Tetrabenazine) [Recruiting]
The purpose of this research study is to see if tetrabenazine, which is commonly used to
treat Huntington's Disease (HD), reduces the problems of impulsivity that are common in
patients with HD. Investigators will also see how the medicine affects aspects of thinking
Xenazine in Late Dyskinetic Syndrome With Neuroleptics [Active, not recruiting]
Late dyskinetic syndrome with neuroleptics, or tardive dyskinesia, is the appearance of
abnormal involuntary movements (AIM) in patients treated with antipsychotics for at least
three months. This important public health issue arises for 15-20% of patients treated with
neuroleptics, the most prescribed psychotropic drugs in mental disorders in France, and
seriously impacts the patients' quality of life. In over 50% of cases, it is
irreversible-that is to say that he will persist despite discontinuation of the offending
Risk factors have been described: the age and female gender are established, a higher dosage
of antipsychotic, a long-term treatment, a psychiatric condition other than schizophrenia
are likely risk factors, intermittent treatment, previous acute dyskinesia, neuroleptics or
powerful, longer term use of corrective treatments including anticholinergics are still
Apart from preventive treatment, which consists in using antipsychotics as being coerced,
support is disappointing: the etiological treatment, which is to stop the offending
antipsychotic, is effective only in less than 50% of cases, the syndrome is most often late
irreversible. Must still have the possibility to interrupt the treatment, which is usually
impossible in the risk of decompensation of the mental illness for which the neuroleptic was
prescribed. Remains symptomatic treatment: functional neurosurgery is only for extreme
cases, because it is not without risk, in terms of morbidity and mortality. So it's the
medication that is most often offered: many drugs have been proposed, a direct result of the
multiplicity of neurotransmitter systems implicated.
However, in the vast majority of cases, this approach is disappointing not to say
ineffective. The only exception is the tetrabenazine, marketed under the name of Xenazine®.
Empirically, neurologists specializing in pathology of the movement are almost unanimous:
its efficiency is very good, with good tolerance. Some preliminary studies have reinforced
this impression. However, their level of evidence remains low and that is why the
investigators propose to implement a prospective multicenter clinical trial, double-blind
with placebo which will include two groups of 27 patients.
Effect of Tetrabenazine on Stroop Interference in HD [Recruiting]
Tetrabenazine has been shown to improve gating of abnormal visual stimuli and improve
postural stability in Huntington disease (HD) patients as measured by computerized dynamic
posturography testing. This study aims to elucidate whether partial dopaminergic depletion
via low dose tetrabenazine has a similar effect on masking out of abnormal visual stimuli on
the Stroop interference test.
Neuroleptic and Huntington Disease Comparison of : Olanzapine, la Tetrabenazine and Tiapride [Recruiting]
Huntington's disease (HD) is autosomal dominant neurodegenerative disease, starting in
average (with high variability) in the fourth decade. The disease progression is classically
characterized by a cognitive deterioration (cortical-frontal dementia), motor disorders
(associating chorea, dystonia and bradykinesia), psychiatric disturbances (combining
depression and irritability) and metabolic disorder (cachexia). The disease is fatal within
15 to 20 years in most patients. HD has no cure. Neuroleptics are the main drug used and the
only to demonstrate its efficacy on chorea in clinical trials. But neuroleptics have also
beneficial and adverse effects on other disease characteristics (motor, psychiatric,
cognitive or metabolic). Their profile between beneficial and adverse effects could be
different according the neuroleptics and their classification. The aim of this study is to
compare beneficial and adverse effects of 3 different neuroleptics in HD.
A Study of the Effectiveness and Safety of Tetrabenazine MR in Pediatric Subjects With Tourette's Syndrome [Withdrawn]
The purpose of this clinical trial is to study the therapeutic effect of tetrabenazine MR in
children with Tourette's Syndrome, as measured by the improvement in total tic score of the
Yale Global Tic Severity Scale (YGTSS).
Reports of Suspected Xenazine (Tetrabenazine) Side Effects
Suicidal Ideation (20),
Condition Aggravated (20),
Huntington's Disease (18),
Pneumonia (16), more >>
Page last updated: 2013-02-10