Deutetrabenazine and valbenazine are prescribed to stop tardive dyskinesia. Deutetrabenazine and valbenazine inhibit vesicular monoamine transporter 2 (VMAT2). VMAT2 transports neurotransmitters such as dopamine, norepinephrine, serotonin, and histamine from the cytosol of cells into synaptic vesicles from which neurotransmitters can then be released into synapses. VMAT2 is also necessary for the vesicular release of the neurotransmitter, GABA, into synapses. With VMAT2 inhibited a wide range of neurotransmitters needed for mood and cognition cannot be released into synapses so can not be effective. Deutetrabenazine and valbenazine have the ring of chemical lobotomies. Deutetrabenazine and valbenazine would also in probability be taken with antipsychotics. Mental health professionals now hold deutetrabenazine and valbenazine are treatment advance for individuals with schizophrenia. Deutetrabenazine and valbenazine can cause Parkinsonism but there are anti-cholinergics for Parkinsonism where individuals in all probability would still be on antipsychotics.
The correct answer in terms of what to do about tardive dyskinesia is to from the start use the very lowest effective dosage of an antipychotic so individuals with major mental illnesses are safe for themselves and others but still could be strange, use 2nd generation antipsychotics which are associated with lower incidences of tardive dyskinesia and never take or prescribe more than a single antipsychotic at a time. In Sweden 25% of patients dispensed antipsychotic drugs receive a combination of two or more antipsychotic drugs. In Asia 32% of patients with schizophrenia get two or more antipsychotics while in North America 16% get two or more antipsychotics There are only so many dopamine D2 receptors to fill. Prescribing more than one antipsychotic at a time is ludicrous.