{"id":60795,"date":"2024-02-28T07:08:53","date_gmt":"2024-02-28T07:08:53","guid":{"rendered":"https:\/\/medsname.com\/atrest\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"atrest","status":"publish","type":"product","link":"https:\/\/medsbase.com\/nl\/atrest\/","title":{"rendered":"Atrest"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">&#9889; Quick Answer &mdash; What is Atrest?<\/h3>\n<p style=\"margin:0;\"><strong>Atrest<\/strong> is een oraal <strong>tetrabenazine<\/strong> (12.5 mg) tablet \u2014 a <strong>VMAT2 (vesicular monoamine transporter 2) inhibitor<\/strong> specifically approved for the treatment of <strong>chorea associated with Huntington disease<\/strong>. It works by depleting dopamine from nerve terminals, reducing the involuntary writhing and jerking movements that characterise Huntington chorea. Starting dose: <strong>12,5 mg eenmaal daags<\/strong>, increased weekly by 12.5 mg to a maximum of <strong>37.5 mg\/dose (75&ndash;100 mg\/day)<\/strong>, always divided into 2&ndash;3 doses. Patients receiving &gt;50 mg\/day require <strong>CYP2D6 genotyping<\/strong>. Common side effects: sedation, akathisia, depression, parkinsonism, insomnia. <strong>Black-box warning:<\/strong> increases risk of depression and suicidality in Huntington patients \u2014 monitor mood closely.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Wat u krijgt bij MedsBase:<\/strong> WHO-GMP gecertificeerde fabrikant \u00b7 Discrete verpakking \u00b7 Wereldwijde verzending \u00b7 1.400+ geverifieerde <a href=\"https:\/\/medsbase.com\/nl\/reviews\/\">klantbeoordelingen<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Elke bestelling is gedekt door onze <a href=\"https:\/\/medsbase.com\/nl\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 als uw pakket niet binnen 20 werkdagen arriveert, sturen wij het opnieuw.<\/p>\n<h3>Waarom bestellen bij MedsBase<\/h3>\n<p>Onze generieke medicijnen zijn afkomstig van WHO-GMP gecertificeerde fabrikanten en worden wereldwijd verzonden in discrete, eenvoudige verpakkingen \u2014 geen medicijnnaam op de buitenkant van het pakket. Betalingen met kaart worden verwerkt via een gereguleerde processor (betalingsoverzichten vermelden een gereguleerde kaartbetalingprocessor \u2014 nooit \u201cMedsBase\u201d of een medicijnnaam). Crypto en SEPA bankoverschrijvingen worden ook geaccepteerd. Elke bestelling wordt ondersteund door ons Reshipment Assurance Policy.<\/p>\n<h2 class=\"wp-block-heading\">What Is Atrest?<\/h2>\n<p>Atrest is an oral tablet containing <strong>tetrabenazine 12.5 mg<\/strong>. Tetrabenazine is a <strong>vesicular monoamine transporter 2 (VMAT2) inhibitor<\/strong> &mdash; the first drug specifically approved for the treatment of <strong>chorea associated with Huntington disease<\/strong>.<\/p>\n<p>By depleting presynaptic dopamine stores, tetrabenazine reduces the involuntary, dance-like movements (chorea) that characterise Huntington disease without the tardive dyskinesia risk of traditional dopamine receptor blockers. It was first used in Europe in the 1970s and gained FDA approval in 2008 as <strong>Xenazine<\/strong>. Atrest is manufactured by a WHO-GMP certified facility and is bioequivalent to the originator brand at the same strength.<\/p>\n<h2 class=\"wp-block-heading\">How Does Atrest (Tetrabenazine) Work?<\/h2>\n<p>Tetrabenazine irreversibly inhibits <strong>VMAT2<\/strong>, the protein responsible for packaging dopamine, serotonin, and norepinephrine into synaptic vesicles. By blocking VMAT2, the drug depletes presynaptic monoamine stores \u2014 predominantly dopamine in the basal ganglia. Excessive dopaminergic activity in the striatum is the primary driver of choreiform movements in Huntington disease, so reducing dopamine availability at the post-synaptic receptor directly suppresses chorea.<\/p>\n<p>The drug is extensively metabolised by CYP2D6 into two active metabolites (&alpha;-HTBZ and &beta;-HTBZ) that account for most of the clinical effect. <strong>CYP2D6 poor metabolisers<\/strong> have significantly higher plasma levels, which is why genotyping is required before exceeding 50 mg\/day.<\/p>\n<h2 class=\"wp-block-heading\">Dosering en toediening<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:0 0 24px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px 14px;text-align:left;\">Week<\/th>\n<th style=\"padding:10px 14px;text-align:left;\">Daily Dose<\/th>\n<th style=\"padding:10px 14px;text-align:left;\">Schema<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px 14px;\">Week 1<\/td>\n<td style=\"padding:10px 14px;\">12.5 mg<\/td>\n<td style=\"padding:10px 14px;\">Once daily (morning)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Week 2<\/td>\n<td style=\"padding:10px 14px;\">25 mg<\/td>\n<td style=\"padding:10px 14px;\">12.5 mg twice daily<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 14px;\">Week 3+<\/td>\n<td style=\"padding:10px 14px;\">37.5&ndash;50 mg<\/td>\n<td style=\"padding:10px 14px;\">Divided into 2&ndash;3 doses<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Maximum<\/td>\n<td style=\"padding:10px 14px;\">75&ndash;100 mg\/day*<\/td>\n<td style=\"padding:10px 14px;\">*CYP2D6 genotyping required &gt;50 mg\/day<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Innemen met of zonder voedsel. <strong>No single dose should exceed 37.5 mg.<\/strong> If treatment is interrupted for &gt;5 days, re-titrate from 12.5 mg.<\/p>\n<h2 class=\"wp-block-heading\">Bijwerkingen<\/h2>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:0 0 16px 0;border-radius:4px;\"><strong>&#9888; Black-box warning \u2014 Depression &amp; suicidality:<\/strong> Tetrabenazine increases the risk of depression and suicidal thoughts\/behaviour in patients with Huntington disease. Do not use in patients who are actively suicidal or have untreated\/inadequately treated depression. Patients and caregivers should be alerted to monitor for emerging or worsening depression, suicidality, or unusual changes in behaviour.<\/div>\n<p><strong>Vaak (\u226510%):<\/strong> sedation\/somnolence, fatigue, insomnia, depression, akathisia (restlessness), anxiety, nausea.<\/p>\n<p><strong>Ernstig:<\/strong> parkinsonism (dose-related), neuroleptic malignant syndrome (rare), QTc prolongation (avoid in congenital long-QT syndrome), dysphagia (increased aspiration risk in Huntington patients).<\/p>\n<h2 class=\"wp-block-heading\">Waarschuwingen en voorzorgsmaatregelen<\/h2>\n<ul>\n<li><strong>Depression and suicidality &mdash; FDA black-box warning.<\/strong> Tetrabenazine increases the risk of depression and suicidal ideation\/behaviour in Huntington disease patients, who already have a high baseline suicide rate (~5&ndash;10%). Assess for depression before starting. Discontinue if depression worsens or suicidal thoughts emerge.<\/li>\n<li><strong>Neuroleptic malignant syndrome (NMS).<\/strong> Rare but reported. Suspect NMS if the patient develops hyperthermia, rigidity, altered consciousness and autonomic instability. Discontinue immediately.<\/li>\n<li><strong>Parkinsonism.<\/strong> Dopamine depletion can cause bradykinesia, rigidity, tremor and falls. Dose-related &mdash; reduce the dose if parkinsonian features appear.<\/li>\n<li><strong>Dysphagia.<\/strong> Tetrabenazine can worsen swallowing difficulty, which is already a concern in Huntington disease. Aspiration risk increases. Monitor and consider speech-therapy assessment.<\/li>\n<li><strong>QTc prolongation.<\/strong> At doses &gt;50 mg\/day, tetrabenazine prolongs the QT interval. ECG monitoring recommended at higher doses. Avoid combination with other QTc-prolonging drugs.<\/li>\n<li><strong>CYP2D6 poor metabolisers.<\/strong> Tetrabenazine is extensively metabolised by CYP2D6. Poor metabolisers have higher plasma levels and increased toxicity. Maximum dose in CYP2D6 PMs is 50 mg\/day (vs 100 mg\/day in EMs). CYP2D6 genotyping is recommended before exceeding 50 mg\/day.<\/li>\n<li><strong>Leverfunctiestoornis.<\/strong> Contraindicated in patients with hepatic impairment (no dose-adjustment data available).<\/li>\n<li><strong>Driving.<\/strong> Sedation, akathisia and parkinsonism can impair driving. Avoid until stable on dose.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contraindications &mdash; Who Should NOT Take Atrest<\/h2>\n<ul>\n<li>Actively suicidal or inadequately treated depression<\/li>\n<li>Leverfunctiestoornis<\/li>\n<li>Concurrent use of <strong>MAO-remmers<\/strong> (hypertensive crisis risk)<\/li>\n<li>Concurrent use of <strong>reserpine<\/strong> (additive dopamine\/serotonin depletion)<\/li>\n<li>Known hypersensitivity to tetrabenazine or any excipient<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Geneesmiddelinteracties<\/h2>\n<ul>\n<li><strong>MAO inhibitors:<\/strong> Contraindicated \u2014 risk of hypertensive crisis. Wait \u226514 days after stopping an MAOI before starting tetrabenazine.<\/li>\n<li><strong>Sterke CYP2D6-remmers<\/strong> (fluoxetine, paroxetine, quinidine): Increase tetrabenazine exposure \u2014 dose reduction required.<\/li>\n<li><strong>Reserpine:<\/strong> Contraindicated \u2014 additive monoamine depletion. Wait \u226520 days between agents.<\/li>\n<li><strong>Dopamine antagonists<\/strong> (antipsychotics, metoclopramide): Additive parkinsonism and akathisia risk.<\/li>\n<li><strong>Alcohol &amp; CNS depressants:<\/strong> Enhanced sedation \u2014 avoid or use cautiously.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Bewaaradvies<\/h2>\n<ul>\n<li>Bewaren bij kamertemperatuur, <strong>15\u201330\u00b0C<\/strong>. Bescherm tegen vocht.<\/li>\n<li>Keep in original packaging until use.<\/li>\n<li>Buiten bereik van kinderen houden.<\/li>\n<li>Gebruik niet na de vervaldatum.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Gerelateerde categorie\u00ebn op MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/neurological-conditions-and-epilepsy\/\">Bekijk alle neurologische &amp; epilepsiemedicijnen<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/mental-health-and-psychiatric-medications\/\">Bekijk medicijnen voor geestelijke gezondheid &amp; psychiatrie<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">Veelgestelde vragen<\/h2>\n<h3 class=\"wp-block-heading\">What is Atrest used for?<\/h3>\n<p>Atrest contains <strong>tetrabenazine 12.5 mg<\/strong> and is used to treat <strong>chorea (involuntary movements) associated with Huntington disease<\/strong>. It is the first drug specifically approved for this indication. It may also be used off-label for tardive dyskinesia and other hyperkinetic movement disorders.<\/p>\n<h3 class=\"wp-block-heading\">How long does tetrabenazine take to reduce chorea?<\/h3>\n<p>Chorea reduction is typically noticeable within <strong>1\u20132 weken<\/strong> of reaching a therapeutic dose during titration. The TETRA-HD trial showed a significant reduction in chorea scores after a mean maintenance dose of ~50 mg\/day over 12 weeks.<\/p>\n<h3 class=\"wp-block-heading\">Why does tetrabenazine require CYP2D6 genotyping?<\/h3>\n<p>Tetrabenazine is metabolised by CYP2D6 into active metabolites. <strong>Poor metabolisers<\/strong> (5&ndash;10% of Caucasians) have significantly higher drug exposure and are at greater risk of adverse effects. Genotyping is required before exceeding 50 mg\/day to set a safe dose ceiling.<\/p>\n<h3 class=\"wp-block-heading\">Can I stop Atrest suddenly?<\/h3>\n<p>Abrupt discontinuation is generally well-tolerated (chorea returns but does not rebound beyond baseline). However, if you have been on the drug for months, a gradual taper over 1&ndash;2 weeks is prudent to monitor for mood changes. If interrupted for &gt;5 days, re-titrate from 12.5 mg.<\/p>\n<h3 class=\"wp-block-heading\">What is the difference between tetrabenazine and deutetrabenazine?<\/h3>\n<p>Deutetrabenazine (Austedo) is the deuterated form \u2014 the same molecule with deuterium atoms replacing hydrogen at key positions. This slows CYP2D6 metabolism, resulting in <strong>longer half-life, lower peak levels, and twice-daily dosing<\/strong> instead of three times daily. Deutetrabenazine also carries a lower incidence of somnolence in trials.<\/p>\n<h3 class=\"wp-block-heading\">Does tetrabenazine cause parkinsonism?<\/h3>\n<p>Yes \u2014 because it depletes dopamine, it can produce dose-related <strong>parkinsonian symptoms<\/strong> (bradykinesia, rigidity, tremor). This usually resolves with dose reduction. The goal is to find the lowest dose that adequately controls chorea without producing parkinsonism.<\/p>\n<h3 class=\"wp-block-heading\">Is Atrest the same as Xenazine?<\/h3>\n<p>Both contain tetrabenazine. Xenazine is the original brand manufactured by Lundbeck. Atrest is a generic-equivalent tablet with the same active ingredient, strength (12.5 mg), and bioavailability at a lower cost.<\/p>\n<h3 class=\"wp-block-heading\">Can tetrabenazine be used for tardive dyskinesia?<\/h3>\n<p>Tetrabenazine is used <strong>. De door de FDA goedgekeurde medicijnen voor vrouwelijke hypoactieve seksuele verlangensstoornis (HSDD) en vrouwelijke seksuele opwindingsstoornis (FSAD) zijn<\/strong> for tardive dyskinesia (TD) and has shown benefit in case series and small trials. However, <strong>valbenazine (Ingrezza)<\/strong> en <strong>deutetrabenazine (Austedo)<\/strong> are specifically FDA-approved for TD and are generally preferred.<\/p>\n<h3 class=\"wp-block-heading\">Can I drink alcohol while taking Atrest?<\/h3>\n<p>Alcohol adds to the sedation and CNS-depressant effects of tetrabenazine. It also worsens depression \u2014 a significant concern given the black-box warning. <strong>Avoid alcohol or limit intake significantly.<\/strong><\/p>\n<h3 class=\"wp-block-heading\">Wat moet ik doen als ik een dosis heb gemist?<\/h3>\n<p>Take the missed dose as soon as you remember, unless it is almost time for the next dose. Do not double up. If you miss doses for 5 or more consecutive days, contact your prescriber \u2014 re-titration from the starting dose may be necessary.<\/p>\n<h3 class=\"wp-block-heading\">Does Atrest interact with antidepressants?<\/h3>\n<p>SSRIs and SNRIs that strongly inhibit CYP2D6 (fluoxetine, paroxetine) will increase tetrabenazine levels \u2014 dose adjustment is required. Weaker CYP2D6 inhibitors (sertraline, citalopram, escitalopram) are safer choices if an antidepressant is needed alongside tetrabenazine.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;font-size:13px;\"><strong>Medische disclaimer:<\/strong> Deze pagina is alleen voor informatieve doeleinden en vervangt geen professioneel medisch advies. Raadpleeg altijd een gekwalificeerde zorgverlener voordat u begint, verandert of stopt met een medicatie. Doseringinformatie weerspiegelt de fabrikantlabeling en gepubliceerde klinische richtlijnen \u2014 individuele behoeften kunnen verschillen.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Gerelateerde alternatieven<\/h3>\n<p>Andere producten in <strong>Chronische aandoeningen<\/strong> die klanten ook bekijken:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/nl\/meftal-p\/\">Meftal-P<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/glide\/\">Glide<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/pioz-15\/\">Pioz 15<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/simvotin\/\">Simvotin<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/nl\/atenheal\/\">Atenheal<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Reduces involuntary movements<br \/>\n\u2705 Controls chorea symptoms<br \/>\n\u2705 Enhances motor function<br \/>\n\u2705 Verbetert de kwaliteit van leven<br \/>\n\u2705 Minimizes muscle spasms<\/p>\n<p>Atrest contains Tetrabenazine.<\/p>","protected":false},"featured_media":60796,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3468],"product_tag":[4924,4925],"class_list":{"0":"post-60795","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-neurological-conditions-and-epilepsy","9":"product_tag-atrest","10":"product_tag-tetrabenazine","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product\/60795","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/comments?post=60795"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media\/60796"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/media?parent=60795"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_brand?post=60795"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_cat?post=60795"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/nl\/wp-json\/wp\/v2\/product_tag?post=60795"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}