Valbenazine
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
Valbenazine: From Tardive Dyskinesia to Psychogenic Movement Disorders
One-Sentence Summary
Valbenazine is a VMAT2 inhibitor originally used to treat tardive dyskinesia, a movement disorder caused by long-term exposure to dopamine-blocking drugs. The TxGNN model predicts it may be effective for psychogenic movement disorders, but there are currently no clinical trials and no publications supporting this specific prediction, so it rests on model output alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Tardive dyskinesia; lingual-facial-buccal dyskinesia |
| Predicted New Indication | Psychogenic movement disorders |
| TxGNN Prediction Score | 99.82% |
| Evidence Level | L5 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 1 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
The Singapore registration record does not state an approved indication. The original indications above come from the TxGNN knowledge graph. Detailed mechanism-of-action data were not available in the data compiled for this report. Valbenazine is known as a selective VMAT2 inhibitor. By blocking VMAT2, it reduces presynaptic dopamine release, which counteracts the dopamine receptor hypersensitivity that develops after chronic exposure to dopamine blockers.
In theory, lowering dopamine release could dampen hyperkinetic movements in general, which is probably why the model links tardive dyskinesia to this new condition. However, psychogenic (functional) movement disorders are not mainly dopaminergic in origin. No trials or publications support valbenazine in this setting, so the mechanistic link is weak and speculative.
Clinical Trial Evidence
Currently no related clinical trials registered for this indication.
Literature Evidence
Currently no related literature available for this indication.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form |
|---|---|---|
| SIN16198P | REMLEAS HARD CAPSULES 40 MG | Capsule, gelatin coated (oral) |
The product is a single-ingredient, valid registration manufactured by Patheon France S.A.S.
Safety Considerations
- Drug Interactions: The interaction screening returned 100 interacting drugs. The first 20 returned are listed here:
- Major: bupropion, clarithromycin, dolasetron
- Moderate: famotidine, loperamide, morphine, bisacodyl, levofloxacin, metoclopramide, palonosetron, dronabinol, nabilone, naldemedine, diphenoxylate, difenoxin, lactitol, picosulfuric acid, sodium sulfate, and polyethylene glycol with electrolytes
- Minor: metronidazole
Please refer to the package insert for warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is very high (99.82%), but it is the only support: no trials, no publications, and a weak mechanistic fit with a condition that is not mainly dopaminergic. This is a model-only (L5) signal and does not justify moving forward.
To proceed, the following is needed:
- Any clinical or case-level evidence of valbenazine in functional or psychogenic movement disorders
- Mechanism of action data and the Singapore package insert, including warnings and contraindications
- A review of the major interactions (bupropion, clarithromycin, dolasetron) for the likely patient population
Other candidates in the same prediction list:
- Chronic tic disorder has more support: indirect literature, including a clinical development review in Tourette syndrome, a 2025 case report, and a 2026 systematic review and meta-analysis. It is rated L4 and classed as a research question, so it is a better candidate to pursue first.
- Drug-induced dyskinesia corresponds to the existing tardive dyskinesia indication, backed by Phase 3 and Phase 4 evidence, so it is not true repurposing.
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.