Ingrezza (valbenazine) is a prescription medication FDA-approved to treat two conditions: tardive dyskinesia in adults and chorea associated with Huntington’s disease. Both conditions involve involuntary movements that can significantly interfere with daily life, and Ingrezza works by regulating a specific chemical transport system in the brain that controls movement.
Tardive Dyskinesia
Tardive dyskinesia (TD) is the condition Ingrezza was originally approved to treat. TD causes repetitive, involuntary movements, most often in the face and mouth. You might notice lip smacking, tongue thrusting, grimacing, or rapid blinking. Some people also develop uncontrollable movements in their arms, legs, or torso. These movements aren’t just uncomfortable. They can make eating, speaking, and social interaction difficult.
TD typically develops as a side effect of long-term use of certain psychiatric medications, particularly older antipsychotics used to treat schizophrenia, bipolar disorder, and depression. The longer someone takes these medications, the higher the risk. Stopping the medication that caused TD doesn’t always make the movements go away, which is why a targeted treatment like Ingrezza exists.
In clinical trials, about 58% of patients treated with Ingrezza reached a remission threshold by week 24, meaning their involuntary movements improved enough to be considered resolved or nearly resolved. This held true regardless of whether symptoms were mild or more severe before treatment. Some patients saw improvement even earlier than previously expected.
Chorea in Huntington’s Disease
Ingrezza’s second approved use is for chorea, the jerky, dance-like involuntary movements that are a hallmark of Huntington’s disease. Huntington’s is a progressive genetic condition that gradually breaks down nerve cells in the brain, affecting movement, cognition, and mood. Chorea is often one of the most visible and disruptive symptoms, making coordinated tasks like walking, dressing, or holding objects unpredictable.
The approval was based on the KINECT-HD trial, published in The Lancet Neurology, which measured chorea severity on a standardized scale. Patients taking Ingrezza saw their chorea scores drop by 4.6 points on average, compared to just 1.4 points for those on placebo. That 3.2-point difference was statistically significant and represented a meaningful reduction in the frequency and severity of involuntary movements for many participants.
How Ingrezza Works
Ingrezza belongs to a class of drugs called VMAT2 inhibitors. To understand what that means in practical terms: your brain uses a protein called VMAT2 to package a chemical messenger (dopamine) into tiny storage compartments inside nerve cells. Too much dopamine signaling in certain movement-control areas of the brain can drive the involuntary movements seen in both tardive dyskinesia and Huntington’s chorea. Ingrezza partially blocks VMAT2, which reduces the amount of dopamine available for release. This helps calm the overactive signaling without shutting it down entirely.
What Taking Ingrezza Looks Like
Ingrezza is taken once daily as a capsule. Treatment starts at 40 mg for the first week, then increases to the standard dose of 80 mg. Some people stay at 40 mg or move to an intermediate 60 mg dose depending on how they respond and how well they tolerate the medication. It’s also available as a sprinkle formulation for people who have difficulty swallowing capsules.
You won’t necessarily see results in the first few days. Clinical data suggests improvements build over weeks, with meaningful changes often emerging within the first several weeks and continuing to develop through roughly six months of treatment. Patience during the early period is important, as the medication needs time to shift dopamine activity gradually.
Important Safety Information
Ingrezza carries an FDA boxed warning, the most serious type, specifically for patients with Huntington’s disease. VMAT2 inhibitors can increase the risk of depression, suicidal thoughts, and suicidal behavior in this population. Huntington’s disease itself already raises the baseline risk of depression and suicidal ideation, and the medication can compound that. Caregivers and family members should watch closely for mood changes, withdrawal, or unusual behavior, especially early in treatment or after dose changes.
This boxed warning applies specifically to the Huntington’s disease indication. It does not appear in the same form for tardive dyskinesia patients, though any mood changes during treatment are worth discussing with a prescriber.
Common side effects reported in clinical trials include drowsiness and sedation. Because Ingrezza affects dopamine signaling, it can also interact with other medications that are processed through the same liver enzymes. If you take strong inhibitors of certain liver enzymes, your prescriber may need to adjust your Ingrezza dose to avoid the drug building up to higher-than-intended levels in your system.
Who Ingrezza Is Not For
Ingrezza is approved only for adults. It has not been studied or approved for children or adolescents with either condition. It’s also not a general-purpose movement disorder treatment. It targets the specific dopamine-driven mechanisms behind tardive dyskinesia and Huntington’s chorea, so it wouldn’t be expected to help with other types of tremor or movement problems like those seen in Parkinson’s disease or essential tremor, which involve different underlying pathways.