Ketogenic diet may help restore metabolic health in psychiatric symptoms: Study

The ketogenic diet may help restore metabolic health in psychiatric symptoms suggests a study published in the Psychiatry Research.

The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4–month pilot study to investigate the effects of a KD on individuals with schizophrenia or bipolar disorder with existing metabolic abnormalities. Twenty–three participants were enrolled in a single–arm trial. Results showcased improvements in metabolic health, with no participants meeting metabolic syndrome criteria by study conclusion. Adherent individuals experienced significant reduction in weight (12 %), BMI (12 %), waist circumference (13 %), and visceral adipose tissue (36 %). Observed biomarker enhancements in this population include a 27 % decrease in HOMA–IR, and a 25 % drop in triglyceride levels. In psychiatric measurements, participants with schizophrenia showed a 32 % reduction in Brief Psychiatric Rating Scale scores. Overall Clinical Global Impression (CGI) severity improved by an average of 31 %, and the proportion of participants that started with elevated symptomatology improved at least 1–point on CGI (79 %). Psychiatric outcomes across the cohort encompassed increased life satisfaction (17 %) and enhanced sleep quality (19 %). This pilot trial underscores the potential advantages of adjunctive ketogenic dietary treatment in individuals grappling with serious mental illness.

Reference:

Shebani Sethi, Diane Wakeham, Terence Ketter, Farnaz Hooshmand, Julia Bjornstad, Blair Richards, Eric Westman, Ronald M Krauss, Laura Saslow. Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial, Psychiatry Research, Volume 335, 2024, 115866, ISSN 0165-1781, https://doi.org/10.1016/j.psychres.2024.115866.

(https://www.sciencedirect.com/science/article/pii/S0165178124001513)

Keywords:

Ketogenic diet, restore, metabolic, health, psychiatric symptoms, study, Bipolar illness; Schizoaffective disorder; Ketogenic diet metabolic therapy; Insulin resistance; Obesity; Metabolic psychiatry; Metabolic syndrome; Psychiatric disease; Clinical trial; Mental health, Shebani Sethi, Diane Wakeham, Terence Ketter, Farnaz Hooshmand, Julia Bjornstad, Blair Richards, Eric Westman, Ronald M Krauss, Laura Saslow, Psychiatry Research

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Robotic technology may potentially improve precision and accuracy in prosthetic dentistry: Study

Robotic technology may potentially improve precision and accuracy in prosthetic dentistry suggests a study published in the Journal of Prosthetic Dentistry.

With the increasing interest in using robots in dentistry and the widespread dissemination of information on this topic and its applications, a comprehensive review of robot applications in prosthodontics is needed. The purpose of this scoping review was to assess the current status of prosthodontic robotic applications, their achievements to date, and the barriers hindering their broader adoption and further advancement. The checklist for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was used to conduct this review. A comprehensive search methodology was developed to identify relevant studies on the use of robots in prosthodontic procedures in the PubMed, Scopus, Web of Science, and Google Scholar databases. The inclusion criteria were studies that specifically outlined the application of robots in the field of prosthodontics. Results: Eighteen relevant studies were found. Of these, 10 studies focused on assessing the effectiveness of robotic systems through in vitro testing using phantom models for tooth preparation. These studies specifically explored the processes involved in creating complete crowns and veneers. The remaining 8 studies investigated the use of robotics in tooth alignment, with a specific focus on complete dentures. Robots have the potential to improve precision and accuracy in prosthetic dentistry. However, clinical studies are needed to confirm the widespread use of robots in prosthodontics, as their clinical application is still in its early stages.

Reference:

Alqutaibi AY, Hamadallah HH, Alturki KN, Aljuhani FM, Aloufi AM, Alghauli MA. Practical applications of robots in prosthodontics for tooth preparation and denture tooth arrangement: A scoping review. J Prosthet Dent. 2024 Mar 12:S0022-3913(24)00120-3. doi: 10.1016/j.prosdent.2024.02.006. Epub ahead of print. PMID: 38480014.

Keywords:

Robotic, technology, potentially, improve, precision, accuracy, prosthetic dentistry, study, Alqutaibi AY, Hamadallah HH, Alturki KN, Aljuhani FM, Aloufi AM, Alghauli MA, Journal of Prosthetic Dentistry

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Routine Abdominal Drainage Not Beneficial in Colorectal Endometriosis Surgeries: Study

A recent study questioned the longstanding practice of using prophylactic abdominal drainage (AD) following colorectal surgery for endometriosis. The key findings were published in the recent issue of European Journal of Obstetrics and Gynecology and Reproductive Biology.

The study spanned from February 2019 to July 2023 and included a total of 215 patients who underwent a minimally invasive procedure to address endometriosis affecting the colorectal area. The research by Adrien Crestani and team employed a propensity score matched analysis to evenly distribute patient characteristics across two groups, where one group received abdominal drainage and the other group did not. This method allowed for a fair comparison of postoperative outcomes between the two sets of patients.

The results were adjusted to account for similar clinical backgrounds and surgical procedures and indicated that patients who had an abdominal drain inserted experienced longer hospital stays and a higher rate of postoperative complications. The statistical analysis showed a significant difference, where the individuals undergoing AD stayed longer in the hospital (p < 0.001) and encountered more complications (p = 0.03) when compared to their counterparts who did not receive a drain.

The study found no significant differences in rates of hospital readmissions, repeat surgeries or severe complications between the two groups by suggesting that the primary differences were confined to length of stay and initial postoperative recovery.

These findings are crucial as they challenge the traditional use of prophylactic abdominal drainage in colorectal surgeries for endometriosis. For years, AD has been routinely employed by surgeons with the belief that it helps by reducing the risk of complications like the infection or fluid accumulation. Also, this study suggests that the practice may be unnecessary and could potentially worsen patient outcomes.

The study adds pivotal evidence to the valuation of routine abdominal drainage in endometriosis surgery and it appears that the practice may need reevaluation in term of these findings which associate it with prolonged hospitalization and increased complications. As this retrospective study brings out detailed data, the results will need to be confirmed through further prospective trials. Overall the implications are significant and could influence future guidelines and standards of care in the treatment of endometriosis involving colorectal surgery. 

Reference:

Crestani, A., de Labrouhe, E., Le Gac, M., Kolanska, K., Ferrier, C., Touboul, C., Dabi, Y., & Darai, E. (2024). To drain or not to drain: A propensity score analysis of abdominal drainage after colorectal surgery for endometriosis. In European Journal of Obstetrics & Gynecology and Reproductive Biology. Elsevier BV. https://doi.org/10.1016/j.ejogrb.2024.04.028

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Magnetic seizure therapy in bipolar mania patients enhance cognitive outcomes: JAMA

A recent study published in the Journal of American Medical Association found Magnetic Seizure Therapy (MST) as a potential alternative to Electroconvulsive Therapy (ECT) for treating bipolar mania by potentially offering fewer cognitive side effects. Bipolar disorder is characterized by extreme mood swings including emotional highs (mania) and lows (depression) which can significantly impair the quality of life. ECT has long been recognized as an effective treatment for severe cases of mania but comes with the drawback of potential cognitive adverse effects like memory loss. So, Shan Chen and team sought for a less invasive option and focused on MST that was not previously tested for bipolar mania.

The randomized clinical trial from the Shanghai Mental Health Center was conducted between July 2017 to April 2021 and included 48 patients who underwent severe episodes of mania. The patients were divided into two groups, where one group received ECT and the other group underwent MST. Both groups participated in 8 to 10 treatment sessions over several weeks with MST being delivered at 100% device output and a frequency of 75 Hz over the vertex. The effectiveness of the treatments was primarily measured by changes in the Young Manic Rating Scale (YMRS) score and the overall response rate was defined as a more than 50% reduction in YMRS score from baseline.

The findings revealed that both MST and ECT had high response rates with efficacy of 95% in the ECT group and 86.4% in the MST group. Also, the outcomes showed no significant difference in the reduction of mania symptoms between the these two therapies by affirming the comparable efficacy of MST. The key differentiator was in the cognitive outcomes, where patients in the MST group expressed significantly better preservation of cognitive functions in language skills when compared to the patients treated with ECT.

This trial is significant as it introduces MST as a pivotal treatment option that could reduce some of the cognitive drawbacks linked with traditional ECT. The outcomes of this study highlight the safety of both treatments as there were no serious adverse effects reported in either group. Overall, the findings of this study suggest that MST could be adopted as a standard therapy for bipolar mania management in patients who are at high risk of cognitive impairment.

Reference:

Chen, S., Sheng, J., Yang, F., Qiao, Y., Wang, W., Wen, H., Yang, Q., Chen, X., & Tang, Y. (2024). Magnetic Seizure Therapy vs Modified Electroconvulsive Therapy in Patients With Bipolar Mania. In JAMA Network Open (Vol. 7, Issue 4, p. e247919). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.7919

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Early Diet Liberalization After Anterior Lumbar Interbody Fusion Improves Postoperative Recovery: Study

Tiffany Bridges et al conducted a study to assess the impact of diet liberalization on short-term outcomes in patients undergoing anterior interbody lumbar fusion (ALIF).

The purpose of the study was to evaluate postoperative outcomes and complications, such as post operative ileus (POI), length of stay (LOS), and urinary retention (POUR) based on diet status following anterior lumbar surgery. The findings of this study may serve to contribute to new spine specific Enhanced Recovery After Surgery (ERAS) protocols which can help surgeons and patients plan for optimization of the postoperative recovery period.

A retrospective review was performed for patients undergoing ALIF at three tertiary care institutions. Electronic medical records were reviewed for demographics, surgical characteristics, and 90-day postoperative outcomes.

Key findings of the study were:

• A total of 515 patients who underwent combined anterior (ALIF) and posterior (PLF or PLDF) lumbar surgery were included in the study.

• In total, 413 patients (80.2%) comprised the “Delayed Diet” group while 102 patients (19.8%) were in the “Full Diet” cohort.

• Demographic data (age, sex, race, ethnicity, BMI, diabetes, smoking status, CCI) was similar amongst both groups other than a greater percentage of male patients in the “Full Diet” group (61.8% vs 45.0%, P = .004)

• All other patients had a delay of at least 1 day (average 1.6 days) until a full diet was provided. This group was found to have a higher rate of postoperative ileus (10.2% vs 2.9%) and urinary retention (16.0% vs 3.9%).

• The readmission rate and percent of patients presenting to the emergency department within 90 days postoperatively were similar.

• On multivariate regression analysis, same-day, full-diet patients had decreased odds of developing urinary retention (OR = .17) and a shorter length of hospital stay (Estimate: -.99).

• Immediate full diet had no impact on the development of ileus (OR: .33).

The authors concluded – “An immediate postoperative full diet following an anterior approach to the lumbar spine was not found to be associated with an increased risk of postoperative ileus in patients deemed appropriate for early diet liberalization. Moreover, an early full diet was found to reduce length of hospitalization and risk of postoperative urinary retention. Reconsideration of postoperative diet protocols may help optimize patient outcomes and recovery.”

Study Design: Retrospective Cohort Study.

Further reading:

Early Diet Liberalization after Anterior Lumbar Interbody Fusion Improves Postoperative Recovery

Tiffany Bridges et al

Global Spine Journal

DOI: 10.1177/21925682231223461

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Regulating cholesterol levels key to improving cancer treatment, finds study

A team of researchers from Aarhus University has made a remarkable discovery that could improve cancer treatment and the treatment of a number of other illnesses.

The key lies in regulating cholesterol levels, which can help make existing treatments more effective.

“We’ve identified a new mechanism that can regulate a crucial immune pathway in the fight against cancer, and this gives us a deeper understanding of how we can activate the body’s own defence against the disease,” explains Professor Martin Roelsgaard Jakobsen from the Department of Biomedicine and one of the last three authors of the study.

Special focus on an essential protein

The researchers have focused on the so-called STING protein, an important element of the immune system’s defence against cancer cells.

By manipulating cholesterol levels, the researchers were able to improve the function of the STING protein, thereby opening up new ways of bolstering the body’s natural defences against cancer.

Effective cancer treatment depends on the strength of the patient’s immune system and how well it can be boosted to kill cancer cells.

According to Martin Roelsgaard Jakobsen, cancer treatment requires a combination of treatment strategies that trigger local immune activation in the tumour, attract cytotoxic T cells, and stimulate broader activation of immune cells.

And this is where the new mechanism presents new opportunities.

“The STING protein has already shown promise in cancer treatment, but we haven’t yet discovered how to activate it in a clinical context. Our research provides a new approach to boosting the activity of the STING protein, giving us another way of harnessing the body’s natural defences against cancer,” he explains.

Result of cross-disciplinary collaboration

The study is the result of an interdisciplinary collaboration between researchers at Aarhus University and Aalborg University, including Martin Roelsgaard Jakobsen and Emil Kofod-Olsen, who are specialists in STING signalling and cancer immunology, and Baocun Zhang and Søren Riis Paludan, who have in-depth knowledge of the molecular biology of the STING protein and its role in a number of illnesses.

The combination of different disciplines has been crucial in linking cholesterol levels with immune responses to cancer.

“Our discovery is a direct result of bringing together experts from different fields. The collaboration has created a unique understanding of how we can fight back against cancer more effectively,” says Martin Roelsgaard Jakobsen.

Could pave the way for several drugs

The discovery of how cholesterol affects the STING protein not only opens new doors to cancer treatment. Researchers also expect the mechanism to play a role in the fight against a number of other illnesses.

“Thanks to increased knowledge about both the mechanism of action in the STING protein and how the protein contributes to a number of illnesses, it is now more likely that a number of new drugs against those illnesses can be developed,” says Professor Søren Riis Paludan.

This would include autoimmune diseases and neurodegenerative diseases, in which the immune system also plays a crucial role.

Reference:

Zhang, Bc., Laursen, M.F., Hu, L. et al. Cholesterol-binding motifs in STING that control endoplasmic reticulum retention mediate anti-tumoral activity of cholesterol-lowering compounds. Nat Commun 15, 2760 (2024). https://doi.org/10.1038/s41467-024-47046-5.

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Ethanol Ablation of Ranulas Shows Promise, but Recurrence Risk Analysis Urged: Study

Korea: Ranulas, those pesky mucous cysts that can form beneath the tongue, have long plagued patients and clinicians alike with their tendency to recur after traditional surgical removal. However, a new study sheds light on a promising alternative treatment: ethanol ablation. While this method shows considerable efficacy, researchers caution that understanding risk factors for recurrence is crucial for optimizing patient outcomes.

The study, published in JAMA Otolaryngology-Head & Neck Surgery, suggests that early ethanol ablation is a treatment option for ranula, however, there is a need for more research to establish the exact role in ranula management.

“In the case-series study of 70 ranula patients, the recurrence rate was 33%, with multivariate analysis showing that the time interval between ranula presentation and ethanol ablation may be a risk factor for recurrence,” the researchers reported.

“Most patients experienced their first recurrence within 12 months following ethanol ablation, with a maximum diameter of 5 cm or higher as a possible risk factor; no risk factors were significantly associated with subsequent surgery.”

Ethanol ablation (EA) involves the injection of ethanol directly into the ranula cavity, causing dehydration and subsequent cyst shrinkage. Unlike traditional surgery, this minimally invasive technique boasts shorter recovery times and reduced risk of complications. However, few studies have assessed long-term outcomes and recurrence of ranula after EA.

Against the above background, Pae Sun Suh, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, and colleagues aimed to evaluate the long-term outcomes and the risk factors for recurrence and receipt of subsequent surgery in patients who underwent treatment with EA for ranula.

For this purpose, the researchers conducted a case-series study at a single tertiary hospital and assessed patients treated with EA between 2009 and 2021. Among 70 consecutive patients, it excluded those with follow-up loss or who were followed up for less than 24 months.

The primary outcome was recurrence at the last follow-up after single or multiple EA sessions. Secondary outcomes included recurrence-free survival (RFS) rate and receipt of subsequent surgery after initial EA. Factors possibly associated with outcomes included patient sex and age; the presentation-to-EA interval; ranula site, type, diameter, volume, and echogenicity; and sublingual gland herniation.

The study led to the following findings:

  • Fifty-seven patients (mean age, 26.4 years; 42% females) were included and were followed up for a median of 57 months.
  • The recurrence rate was 33%, and 19% underwent subsequent surgery.
  • Among patients with recurrence, 86% experienced first recurrence within 12 months after initial EA.
  • A presentation-to-EA interval of 12 months or longer was associated with an increased risk of recurrence (adjusted odds ratio [OR], 3.74).
  • No risk factors were significantly associated with subsequent surgery (highest OR in parapharyngeal space extension: adjusted OR, 4.96).
  • Among the initial cohort of 70 patients, 2-year RFS was lower in maximum diameter of ranula of 5 cm or higher than less than 5 cm (24% versus 50%; difference, 26%).

In conclusion, the case-series study found that the ranula’s recurrence rate after EA was 33%. A presentation-to-EA interval of 12 months or longer may be a risk factor for recurrence, indicating that early intervention with EA might minimize recurrence. Most first recurrences occurred within 12 months following EA, with a maximum diameter of ranula of 5 cm or higher being a possible risk factor.

Reference:

Suh PS, Lee JH, Roh YH, et al. Ethanol Ablation of Ranulas and Risk Factor Analysis for Recurrence. JAMA Otolaryngol Head Neck Surg. Published online May 02, 2024. doi:10.1001/jamaoto.2024.0183

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Ginge-Cal promising material for treatment of infected root canal when used as obturation material: Study

Ginge-Cal is a promising material for treating infected root canals when used as obturation material suggests a study published in the International Journal of Dentistry.

The tendency to use dental materials of plant origin is one of the prevailing trends in dentistry to reduce exposure to materials that could have some toxic impact in the long term. A study was done to evaluate the efficacy of calcium hydroxide combined with gingerols (Ginge-Cal) as a novel obturation material for treating infected primary teeth and decreasing the recurrence of infection. The study was conducted on 30 lower primary molars with infected pulp for children aged 4–8 years. The sample was randomly divided into two groups depending on the tested obturation material: Ginge-Cal group and the Metapex group. The evaluation was done by different parameters clinically and radiographically at various intervals up to 12 months. Results. Based on chi-squared and McNamara’s test with a 5% significance level, the clinical results indicated that Ginge-Cal group was more effective than the Metapex group in reducing or eliminating pain () after 1 week, sensitivity to percussion () at 3 months of follow-up, purulent swelling () at 6 and 9 months of follow-up, fistula, and tooth mobility. The radiographic results, based on the periapical and furcation area radiolucency at 12 months of follow-up, favored Ginge-Cal group over the Metapex group (), (), respectively. There were no statistically significant differences in pathological root resorption and periodontal space. The differences within the Ginge-Cal group were directly influenced by the time intervals in a statistically significant manner, ranging from () to (). The success percentage was 87.5% for Ginge-Cal group and 64.3% for Metapex group. Ginge-Cal can be considered a promising material for treating the infected root canal when used as an obturation material for the infected root canal.

Reference:

Fathi A. Qasem, Salwa M. Awad, Rizk A. Elagamy, “Effectiveness of Calcium Hydroxide and Gingerols Mixture as a Novel Obturation Material for Infected Root in Primary Teeth: A Randomized Clinical Trial”, International Journal of Dentistry, vol. 2024, Article ID 5528260, 10 pages, 2024. https://doi.org/10.1155/2024/5528260

Keywords:

​​Ginge-Cal, promising, material, treatment, infected, root canal, obturation material, study, International Journal of Dentistry, Fathi A. Qasem, Salwa M. Awad, Rizk A. Elagamy

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Hydroxyurea dose escalation enhances clinical outcomes in children with sickle cell anemia: Study

The Realizing Effectiveness Across Continents with Hydroxyurea (REACH) trial unveiled promising results in the treatment of sickle cell anemia among children in sub-Saharan Africa. The findings of this study was published in a recent issue of The Lancet Haematology which highlights the effectiveness of the extended hydroxyurea treatment over a period of 8 years.

This research was conducted across 4 clinical sites in Kenya, Uganda, Angola and the Democratic Republic of Congo by enrolling a total of 635 children aged 1 to 10 years with documented sickle cell anemia. Over the course of the study, 606 children received hydroxyurea treatment, with 522 continued treatment for a median duration of 93 months.

The key findings of this study revealed a significant improvement in the treatment outcomes. The children who received hydroxyurea expressed an increased mean hemoglobin concentration and fetal hemoglobin level along with a reduction in the absolute neutrophil count. The dose escalation to the maximum tolerated dose (MTD) with dose optimization led to a marked reduction in vaso-occlusive episodes, acute chest syndrome events, recurrent stroke events, malaria infections, non-malarial infections, serious adverse events and mortality rates when compared to fixed-dose hydroxyurea.

Incidence rate ratios indicated a substantial decrease in various adverse events that included vaso-occlusive episodes, acute chest syndrome events, and malaria infections, among others. The dose-limiting toxicity rates remained similar between the fixed-dose and MTD phases by suggesting the safety and feasibility of the treatment approach. Also, grade 3 and 4 adverse events were infrequent, with serious adverse events uncommon and no treatment-related deaths were reported. This signifies a significant move in enhancing the quality of life and prognosis for the children battling sickle cell anemia in the region.

As sickle cell anemia poses a significant health burden in sub-Saharan Africa where resources for comprehensive care are often limited, the outcomes of this study were profound. The REACH trial offers hope for the population affected by this hereditary blood disorder by demonstrating the effectiveness and safety of extended hydroxyurea treatment. Overall, this comprehensive trial illuminates the importance of tailored treatment strategies for sickle cell anemia in resource-limited settings.

Source:

Aygun, B., Lane, A., Smart, L. R., Santos, B., Tshilolo, L., Williams, T. N., Olupot-Olupot, P., Stuber, S. E., Tomlinson, G., Latham, T., & Ware, R. E. (2024). Hydroxyurea dose optimisation for children with sickle cell anaemia in sub-Saharan Africa (REACH): extended follow-up of a multicentre, open-label, phase 1/2 trial. In The Lancet Haematology. Elsevier BV. https://doi.org/10.1016/s2352-3026(24)00078-4

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Deutetrabenazine and Valbenazine Safe and Effective Treatments for Tardive Dyskinesia, reveals study

Researchers have found that deutetrabenazine and valbenazine are both safe and effective treatment options for managing tardive dyskinesia (TD), a condition characterized by involuntary, repetitive movements. Published in Tremor and Other Hyperkinetic Movements, the research assessed the results of patients treated with these relatively new therapies. The study was conducted by Golsorkhi and colleagues.

Tardive dyskinesia is a challenging side effect of certain medications used to treat psychiatric conditions and other disorders. First-line treatments include tetrabenazine, approved by the US Food and Drug Administration (FDA) in 2008, as well as deutetrabenazine and valbenazine, approved in 2023 and 2017, respectively. Researchers aimed to compare the newer VMAT2 inhibitors deutetrabenazine and valbenazine against the previously approved tetrabenazine.

The researchers conducted a review of 4 double-blind clinical trials, which included a total of 230 patients. The studies examined the efficacy and safety of deutetrabenazine and valbenazine compared with placebo in adult patients with TD. The review focused on clinical trials involving adult human participants that provided data on Abnormal Involuntary Movement Scale (AIMS) scores, a key measure for TD symptoms.

The key findings of the study were:

  • Both deutetrabenazine and valbenazine were associated with significant reductions in AIMS scores compared to placebo.

  • The majority of patients tolerated deutetrabenazine and valbenazine well, with serious adverse events occurring in only 5% of patients. Approximately 10% of patients required dose reduction or cessation.

  • Both deutetrabenazine and valbenazine have longer half-lives compared to tetrabenazine, allowing for less frequent dosing and increased convenience for patients.

Advantages Over Tetrabenazine

The review found deutetrabenazine and valbenazine to be superior to tetrabenazine in several ways:

  • Both new medications demonstrated fewer side effects compared to tetrabenazine.

  • Neither deutetrabenazine nor valbenazine were associated with increased risk of suicidality.

  • The longer half-lives of deutetrabenazine and valbenazine allow for less frequent dosing, making them more convenient for patients.

While the findings support the use of deutetrabenazine and valbenazine as effective treatment options for TD, the researchers emphasized the need for larger studies, especially in diverse populations, to understand long-term outcomes and assess efficacy across different patient groups.

Deutetrabenazine and valbenazine have shown promise as safe, effective treatments for managing TD, offering fewer side effects and more convenient dosing regimens compared to tetrabenazine. Further research is required to explore their long-term efficacy and safety in broader patient populations.

Reference:

Golsorkhi, M., Koch, J., Pedouim, F., Frei, K., Bondariyan, N., & Dashtipour, K. (2024). Comparative analysis of deutetrabenazine and valbenazine as VMAT2 inhibitors for tardive dyskinesia: A systematic review. Tremor and Other Hyperkinetic Movements (New York, N.Y.), 14(1). https://doi.org/10.5334/tohm.842

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