Original ArticlesA Study of Chorea After Tetrabenazine Withdrawal in Patients With Huntington DiseaseFrank, Samuel MD*; Ondo, William MD†; Fahn, Stanley MD‡; Hunter, Christine RN, PhD†; Oakes, David PhD§; Plumb, Sandra BS, MD∥; Marshall, Frederick MD∥; Shoulson, Ira MD∥; Eberly, Shirley MS, MD§; Walker, Francis MD¶; Factor, Stewart DO, MD#; Hunt, Vicki RN, MD¶; Shinaman, Aileen JD, MD∥; Jankovic, Joseph MD†Author Information *Department of Neurology, Boston University School of Medicine, Boston, MA; †Department of Neurology, Baylor College of Medicine, Houston, TX; ‡Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY; Departments of §Biostatistics and ∥Neurology, University of Rochester School of Medicine, Rochester, NY; ¶Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC; and #Department of Neurology, Emory University School of Medicine, Atlanta, GA. Supported by Prestwick Pharmaceuticals. Address correspondence and reprint requests to Samuel Frank, MD, 715 Albany St, C329, Boston, MA 02118; E-mail: [email protected] Clinical Neuropharmacology: May-June 2008 - Volume 31 - Issue 3 - p 127-133 doi: 10.1097/WNF.0b013e3180ca77ea Buy Metrics Abstract Objective: To assess tetrabenazine (TBZ) efficacy by evaluating the change in Huntington disease-associated chorea resulting from TBZ treatment withdrawal. Methods: Thirty patients treated in the long term were randomized to 1 of 3 groups assigned to withdraw from TBZ in a double-blind, staggered fashion during a 5-day period. Results: The chorea scores of subjects withdrawn from TBZ treatment increased by 5.3 units from days 1 to 3, whereas the scores of the group with partial or no withdrawal of TBZ treatment increased by 3.0 units (P = 0.0773). A post hoc analysis of the linear trend was positive for reemergent chorea (P = 0.0486). No serious adverse events were reported after abrupt withdrawal of TBZ treatment. Conclusions: The trend for reemergence of chorea in patients with Huntington disease who were withdrawn from TBZ treatment is consistent with the findings from previous studies, thus showing the effectiveness of TBZ in reducing chorea. © 2008 Lippincott Williams & Wilkins, Inc.