Table 1.
Class | Medication | FDA Indicated for HD chorea? | Adult dosing1 | Benefit for psychiatric symptoms? | Available generic? | Cost for 30-day supply of lowest target dose2 | ||
---|---|---|---|---|---|---|---|---|
Initial daily dose | Target daily dose | Divided dose? | ||||||
Atypical antipsychotics3 | risperidone | no | 2–3 mg | 1–8 mg | yes | yes | yes | $1.50 |
olanzapine | no | 5–15 mg | 5–20 mg | no | yes | yes | $4.50 | |
aripiprazole | no | 10–15 mg | 10–15 mg | no | yes | yes | $11.18 | |
clozapine | no | 12.5 mg | 300–600 mg | yes | yes | yes | $32.63 | |
quetiapine | no | 25–100 mg | 50–800 mg | yes | yes | yes | $7.80 | |
VMAT-2 inhibitors | tetrabenazine | yes | 12.5 mg | 25–100 mg | yes | no | yes | $430.77 |
deutetrabenazine | yes | 6 mg | 6–48 mg | yes | no | no | $1,916.15 | |
valbenazine | no | 40 mg | 80 mg | no | no | no | $6,649.835 |
Antipsychotic and valbenazine dosing includes monotherapy dose range for all approved indications according; tetrabenazine and deutetrabenazine include only HD approved doses.
Cost estimates are from www.goodrx.com. Costs are lowest listed costs, not accounting for insurance coverage, including available coupons and mail order prices listed on www.goodrx.com as of 10/6/20. For brand name medications, coupons and patient assistance programs typically lower the price, but this is dependent on patient insurance.
First generation antipsychotics and therapies not approved in the US are not included on this list, as we aimed the include the most relevant agents. All antipsychotics listed refer to immediate release oral formulations.
GoodRx pricing was available only for the starting dose pack, not for the 80 mg target dose