# Valbenazine for the Treatment of Chronic Motor or Vocal Tic Disorder (CMVTD)

## TL;DR

Valbenazine showed rapid and sustained improvement in a child with chronic tic disorder who did not respond to other treatments.

## Contribution

This case highlights valbenazine's potential as a treatment for treatment-resistant chronic motor or vocal tic disorder.

## Key findings

- Valbenazine reduced tic severity from 65 to 5 on the YGTSS-R within 48 hours.
- The patient tolerated valbenazine well with sustained clinical benefit.
- The case suggests VMAT2 inhibition may be effective for refractory tic disorders.

## Abstract

Chronic motor or vocal tic disorder (CMVTD) is a distressing neuropsychiatric condition. A subset of patients remains refractory to currently approved therapies. The present report describes a pediatric patient with CMVTD who had previously failed multiple pharmacological treatments, including two Food and Drug Administration (FDA)-approved agents (pimozide, aripiprazole), guanfacine, psychotherapy, and novel compounds (lumateperone, cariprazine). The patient was initiated on valbenazine, titrated to 80 mg daily. Clinical improvement was noted within 24-48 hours, with sustained benefit and good tolerability. Tic severity, measured by the Yale Global Tic Severity Scale-Revised (YGTSS-R), improved from 65 at baseline to five following treatment (net reduction of 60 points). This case illustrates a marked therapeutic response to valbenazine in a patient with CMVTD refractory to conventional and novel therapies. These observations highlight the potential role of vesicular monoamine transporter 2 (VMAT2) inhibition in tic disorders and also the need for further clinical study.