Journal Article (Review Article) DZNE-2025-00940

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Vesicular monoamine transport inhibitors: current uses and future directions.

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2025
Elsevier London [u.a.]

The lancet 406(10503), 650 - 664 () [10.1016/S0140-6736(25)01072-4]

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Abstract: Advancements over the past decade in understanding vesicular monoamine transporter 2 (VMAT2) inhibitors highlight their key role in the treatment of movement and neuropsychiatric disorders. VMAT2 is crucial for packaging neurotransmitters such as serotonin, dopamine, and norepinephrine into synaptic vesicles, facilitating their release and reuptake in synaptic transmission. VMAT2 inhibitors, such as tetrabenazine, deutetrabenazine, and valbenazine, show therapeutic efficacy in managing hyperkinetic movement disorders, including Huntington's disease, tardive dyskinesia, and Tourette's syndrome. These inhibitors modulate excessive synaptic activity by reducing neurotransmitter storage and release. Genetic variations, particularly in the cytochrome P450 enzyme family, influence VMAT2 inhibitor metabolism, necessitating personalised dosing to optimise efficacy and minimise adverse events. Recent studies have provided further structural insights into VMAT2 inhibition mechanisms, paving the way for the development of inhibitors with enhanced potency and selectivity. Leveraging pharmacogenetics for precision medicine and exploring VMAT2 inhibition in broader therapeutic contexts could revolutionise treatment frameworks for neurological and psychiatric conditions.

Keyword(s): Humans (MeSH) ; Vesicular Monoamine Transport Proteins: antagonists & inhibitors (MeSH) ; Vesicular Monoamine Transport Proteins: metabolism (MeSH) ; Tetrabenazine: analogs & derivatives (MeSH) ; Tetrabenazine: therapeutic use (MeSH) ; Tetrabenazine: pharmacology (MeSH) ; Huntington Disease: drug therapy (MeSH) ; Movement Disorders: drug therapy (MeSH) ; Valine: analogs & derivatives (MeSH) ; Vesicular Monoamine Transport Proteins ; Tetrabenazine ; SLC18A2 protein, human ; deutetrabenazine ; valbenazine ; Valine

Classification:

Contributing Institute(s):
  1. Population & Clinical Neuroepidemiology (AG Aziz)
Research Program(s):
  1. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

Appears in the scientific report 2025
Database coverage:
Medline ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 90 ; JCR ; NationallizenzNationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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 Record created 2025-08-11, last modified 2025-08-31


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