Depression and Suicidality

• Tetrabenazine can increase the risk of depression and suicidal thoughts and behavior (suicidality) in patients with Huntington's disease.
• Anyone considering the use of tetrabenazine must balance the risks of depression and suicidality with the clinical need for control of choreiform movements.
• Close observation of patients for the emergence or worsening of depression, suicidality, or unusual changes in behavior should accompany therapy.
• Patients, their caregivers, and families should be informed of the risk of depression and suicidality and should be instructed to report behaviors of concern promptly to the treating physician.
• Particular caution should be exercised in treating patients with a history of depression or prior suicide attempts or ideation, which are increased in frequency in Huntington's disease.
• Tetrabenazine is contraindicated in patients who are actively suicidal, and in patients with untreated or inadequately treated depression.