Austedo works to modulate the amount of dopamine available in the brain in order to regulate the motor side effects associated with psychotropic medication use. Medically speaking, the medication is classified as a selective vesicular monoamine transporter 2 (VMAT2) inhibitor.

There are a myriad of psychiatric conditions that psychotropic medications can treat. They work to balance the serotonin, norepinephrine, and dopamine in the brain.

• Serotonin: A chemical that carries messages between nerve cells in the brain and throughout your body. Serotonin plays a key role in mood, sleep, digestion, nausea, wound healing, bone, health, blood clotting, and sexual desire. (source)
• Norepinephrine: Also known as noradrenaline. It’s a neurotransmitter and a hormone that plays an important role in your body’s “fight-or-flight” response. As a medication, norepinephrine is used to increase and maintain blood pressure in limited, short-term serious health situations. (source)
• Dopamine: A type of neurotransmitter. Your nervous system uses it to send messages between nerve cells. (source)

Sometimes balancing these neurotransmitters is tricky and can cause side effects. One of these common side effects is what we call extrapyramidal symptoms (EPS). Extrapyramidal symptoms can manifest as Tardative Diskenesia, Parkinsonism, and Akathesia. These occur when there is a misbalance of dopamine in the Nigrostriatal Pathway in the brain. This can cause Tardative Diskenesia, a motor disorder identified by its effect on the jaw, tongue, and face, as well as extremities. Parkinsonism is identified by its fine motor tremor of intention, signified by fine tremors in the upper extremities. This term is an umbrella term that encompasses numerous causes whereas Parkinson’s Disease is the degeneration of nerve cells in the brain. Akathesia is a disorder defined by its internal sense of restlessness, which may result in movement such as rocking back and forth or excessive pacing.

There are three main dopamine pathways in the brain.

• Mesolimbic/ Mesocortical: Affects thought and mood. Too much dopamine in the Mesolimbic pathway can result in symptoms of schizophrenia. Schizophrenia is treated with medications that modulate dopamine.

• Tuberofindibular Pathway: Involved in Prolactin modulation in the Pituitary Gland.

• Nigrostriatal Pathway: Responsible for Motor Function. Too little dopamine action in the Nigrostriatal Pathway can cause symptoms of Parkinson’s disease.

EPS Symptoms can manifest in different ways. The most common are Parkinsonism, Trdative Diskenesia, and Akathesia.

Austedo is a new medication changing the way mental health treats EPS symptoms. Since Austedo is a selective vesicular monoamine transporter 2 (VMAT2) inhibitor, it works with the dopamine pathways in the brain as well as the neurotransmitter dopamine to modulate the amount of dopamine available in the presynaptic cleft (the little space between neurons where the dopamine sends the signal to the new neuron). This works to decrease EPS symptoms, and in some cases, eliminate them completely.

The ability to treat the EPS symptoms effectively has greatly increased the treatments available to a patient that may have otherwise had to trial numerous medications to find one with low side effects.