tetrabenazine tetrabenazine tetrabenazine is a drug for the symptomatic treatment of hyperkinetic movement disorders. it is sold under the brand names nitoman and xenazine among others. on august 15, 2008, the u.s. food and drug administration approved the use of tetrabenazine to treat chorea associated with huntington's disease. although other drugs had been used "off label," tetrabenazine was the first approved treatment for huntington's disease in the u.s. the compound has been known since the 1950s. tetrabenazineclinical datatrade namesxenazine, xentra, nitoman, othersother namesro-1-9569ahfs/drugs.comconsumer drug informationpregnancycategory au: b3 routes ofadministrationby mouthatc coden07xx06 (who) legal statuslegal status au: s4 (prescription only) us: ℞-only pharmacokinetic databioavailabilitylow, extensive first pass effectprotein binding82–85%metabolismliver (cyp2d6-mediated)elimination half-life10 hours parent compound (2 to 8 hours active metabolites)excretionkidney (~75%) and fecal (7–16%)identifiers iupac name (ss,rr)-3-isobutyl-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-pyridoisoquinolin-2-one cas number58-46-8 ypubchem cid6018iuphar/bps4834drugbankdb04844 ychemspider5796 yuniiz9o08yrn8okeggd08575 ychemblchembl117785 ycomptox dashboard (epa)dtxsid0042614 echa infocard100.000.348 chemical and physical dataformulac19h27no3molar mass317.429 g·mol−13d model (jsmol)interactive imagechiralityracemic mixture smiles o=c3c(cc(c)c)cn2c(c1c(cc(oc)c(oc)c1)cc2)c3 inchi inchi=1s/c19h27no3/c1-12(2)7-14-11-20-6-5-13-8-18(22-3)19(23-4)9-15(13)16(20)10-17(14)21/h8-9,12,14,16h,5-7,10-11h2,1-4h3 ykey:mkjiefsobyuxjb-uhfffaoysa-n y (verify) medical uses tetrabenazine is used as a treatment, but not as a cure, for hyperkinetic disorders such as: huntington's disease – specifically, the chorea associated with it tourette syndrome and other tic disorders tardive dyskinesia, a serious and sometimes irreversible side effect of long-term use of many antipsychotics, mainly typical antipsychotics hemiballismus, spontaneous flinging limb movements due to contra-lateral subthalamic nucleus damage tetrabenazine has been used as an antipsychotic in the treatment of schizophrenia, both in the past and in modern times. side effects the most common adverse reactions, which have occurred in at least 10% of subjects in studies and at least 5% greater than in subjects who received placebo, have been: sedation or somnolence, fatigue, insomnia, depression, suicidal thoughts, akathisia, anxiety and nausea. warnings there is a boxed warning associated with the use of tetrabenazine: increases the risk of depression and suicidal thoughts and behavior in patients with huntington's disease balance risks of depression and suicidality with the clinical need for control of chorea when considering the use of tetrabenazine monitor patients for emergence or worsening of depression, suicidality or unusual changes in behavior inform patients, caregivers and families of the risk of depression and suicidality and instruct to report behaviours of concern promptly to the treating physician exercise caution when treating patients with a history of depression or prior suicide attempts or ideation tetrabenazine is contraindicated in patients who are actively suicidal and in patients with untreated or inadequately treated depression pharmacology