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wrong image, it is a dimethoxy compound!
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|IUPAC_name = (''SS'',''RR'')-3-Isobutyl-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-pyrido[2,1-''a'']isoquinolin-2-one
|IUPAC_name = (''SS'',''RR'')-3-Isobutyl-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-pyrido[2,1-''a'']isoquinolin-2-one
| synonyms = Ro-1-9569
| synonyms = Ro-1-9569
| image = (RR,SS)-Tetrabenazine Structural Formulae.png
| image = <!-- (RR,SS)-Tetrabenazine Structural Formulae.png wrong, it is a dimethoxy, stereochemistry??? -->
| image2= Tetrabenazine3d.png
| image2= Tetrabenazine3d.png
| CAS_number=58-46-8
| CAS_number=58-46-8

Revision as of 15:23, 16 August 2009

Tetrabenazine
Clinical data
Other namesRo-1-9569
Pregnancy
category
  • C
Routes of
administration		Oral (tablets, 25 mg)
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityLow, extensive first pass effect
Protein binding82–85%
MetabolismHepatic (CYP2D6-mediated)
ExcretionRenal and fecal
Identifiers
  • (SS,RR)-3-Isobutyl-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-pyrido[2,1-a]isoquinolin-2-one
CAS Number
PubChem CID
DrugBank
ChemSpider
CompTox Dashboard (EPA)
ECHA InfoCard100.000.348 Edit this at Wikidata
Chemical and physical data
FormulaC19H27NO3
Molar mass317.427 g/mol g·mol−1

Tetrabenazine is a drug for the symptomatical treatment of hyperkinetic movement disorder and is marketed under the trade names Nitoman in Canada and Xenazine in New Zealand and some parts of Europe, and is also available in the USA as an orphan drug. On August 15, 2008 the U.S. Food and Drug Administration (FDA) approved the use of tetrabenazine to treat chorea associated with Huntington's disease (HD), the first in the US.[1] The compound has been known since the 1950s.

Pharmacology

Tetrabenazine works mainly as a VMAT-inhibitor[2] and as such promotes the early metabolic degradation of the neurotransmitter dopamine.

Uses

Tetrabenazine is used as a treatment, but not a cure for hyperkinetic disorders[3][4] such as:

Side effects

Because tetrabenazine is closely related to the antipsychotics, many of its side effects are similar. Some of these include:[6]

  • Akathisia (aka "restless pacing" – an inability to keep still, with intense anxiety when forced to do so)
  • Depression - the most common side effect, reported in roughly 15% of those who take the medication
  • Dizziness, drowsiness, insomnia, fatigue, nervousness and anxiety
  • Parkinsonism

Unlike many of the antipychotics, tetrabenazine is not known to cause tardive dyskinesia.

Warnings

  • Because of the relatively high incidence of depression, it has been recommended that people with a history of depression avoid taking tetrabenazine.
  • The concomitant intake of MAO inhibitors is contraindicated.

References

  1. ^ 1st US drug for Huntington's disease wins approval
  2. ^ Zheng G, Dwoskin LP, Crooks PA (2006). "Vesicular monoamine transporter 2: role as a novel target for drug development". AAPS J. 8 (4): E682–92. doi:10.1208/aapsj080478. PMID 17233532.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. ^ Jankovic J, Beach J (1997). "Long-term effects of tetrabenazine in hyperkinetic movement disorders". Neurology. 48 (2): 358–62. PMID 9040721.
  4. ^ Kenney C, Hunter C, Jankovic J (2007). "Long-term tolerability of tetrabenazine in the treatment of hyperkinetic movement disorders". Mov. Disord. 22 (2): 193–7. doi:10.1002/mds.21222. PMID 17133512. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  5. ^ Ondo WG, Hanna PA, Jankovic J (1999). "Tetrabenazine treatment for tardive dyskinesia: assessment by randomized videotape protocol". Am J Psychiatry. 156 (8): 1279–81. PMID 10450276. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  6. ^ Robertson MM (2000). "Tourette syndrome, associated conditions and the complexities of treatment". Brain. 123 Pt 3: 425–62. doi:10.1093/brain/123.3.425. PMID 10686169. {{cite journal}}: Unknown parameter |month= ignored (help)

External links


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