7 Austedo Side Effects and How to Manage Them

Uncontrolled body movements are a common experience for those living with Huntington’s disease or tardive dyskinesia. And they’re more than just an annoyance; they can greatly interfere with your quality of life and day-to-day routine.

There’s no cure for Huntington’s disease or tardive dyskinesia. But several treatments can calm down these body movements and improve your well-being. Austedo (deutetrabenazine) is one go-to option. It’s an FDA-approved medication that can help ease uncontrolled body movements from these conditions. It’s available as an immediate-release (IR) and extended-release (XR) tablet.

Austedo is effective for many people, but it’s not without its risks. Like any other medication, it’s important to understand its possible side effects and how to manage them.

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Austedo side effects at a glance

Austedo side effects generally improve over time as your body gets used to the medication. The most common Austedo side effects include:

• Sleepiness

• Fatigue

• Insomnia

• Dry mouth

• Diarrhea

• Common cold symptoms

• Difficulty sleeping

More serious Austedo side effects are possible, too, though rare. They include:

• Depression, including thoughts of suicide or self-harm

• Fast or irregular heartbeat

• Restlessness or movement problems

Below, we’ll discuss the seven most notable side effects of Austedo and how to manage them.

1. Sleeping changes

Sleepiness, or feeling tired, is a common side effect of taking Austedo for Huntington’s disease. It can affect your ability to think, focus, or react.

If you’re feeling tired, make sure to listen to your body and know what its limits are. For instance, avoid driving or operating other forms of heavy machinery if the medication is making you sleepy. 

It’s also best to avoid drinking alcohol or taking other medications that cause sleepiness, such as opioids and benzodiazepines, while taking Austedo. These combinations can drain your energy levels even more.

The opposite effect is true for other people. Insomnia, or difficulty falling asleep, is a common side effect of Austedo in people with tardive dyskinesia.

Some well-studied home remedies to help counteract insomnia are optimizing your sleep hygiene practices, such as creating a relaxing bedtime routine. Practicing meditation and avoiding caffeine and alcohol shortly before bed help, too. Some over-the-counter (OTC) supplements and medications, such as melatonin and occasional doses of Benadryl (diphenhydramine), can also help promote sleep when needed. But it is important to consult your healthcare provider before taking any of these medications.  

Thankfully, once your body starts to get used to this medication, these symptoms should lessen. 

2. Dry mouth

Dry mouth is another common side effect of Austedo. If it persists, ongoing dry mouth can lead to trouble chewing and swallowing. In some cases, cavities and mouth infections can develop.

If you’re experiencing dry mouth, some home remedies can make a difference. Ask your healthcare provider about:

• Chewing on sugar-free gum

• Sucking (not chewing) on ice chips

• Sipping on cold liquids, such as sugar-free drinks and water

• Using saliva substitutes 

• Maintaining good oral hygiene

If your dry mouth feels severe or isn’t improving, speak with your provider about potential next steps. They can offer other management options. In some cases, they may opt to change your medication routine.

3. Diarrhea

Diarrhea is a common side effect of Austedo, too. But it typically doesn’t last very long. This symptom should improve over time as your body gets used to the medication.

If you develop diarrhea, it’s important to stay hydrated and try to replenish the fluids that you’re losing. A good starting point is 8 to 10 glasses of non-sugary liquids per day. Electrolyte drinks can also help replenish lost electrolytes. Temporarily sticking to bland, starchy foods can help soothe your stomach as well.

These dietary interventions aren’t always enough, though. You can also take an OTC anti-diarrheal medication, such as loperamide (Imodium A-D), with your healthcare provider’s OK.

4. Symptoms of the common cold

Some people taking Austedo report having minor respiratory illnesses, such as the common cold. Possible symptoms of the common cold include:

• Sore throat

• Runny nose or stuffy nose

• Cough

• Mucus production

• Body aches

You can treat these symptoms the same way you’ve treated previous colds. Some ways to ease common cold symptoms include the following:

• Stay hydrated.

• Get plenty of rest.

• Use a humidifier or vaporizer.

• Use saline nasal spray.

• Suck on cough drops or throat lozenges.

Some OTC treatment options that can help treat cold symptoms are antihistamines, decongestants, and expectorants. Antihistamines help with allergy-like symptoms, decongestants help with stuffy nose, and expectorants help with mucus production. Speak with your healthcare provider about which medications are best for you before making any purchases.

If symptoms like these don’t get better within 10 days — or if they become severe at any point — contact your healthcare provider without delay. 

5. Restlessness or changes in body movements

Akathisia refers to a sense of restlessness where you feel a strong urge to move. If you have akathisia, you’ll likely experience symptoms like pacing back and forth, rocking while sitting, or shifting your feet while standing. 

These symptoms can happen from taking Austedo. It’s hard to manage these symptoms on your own. If you notice changes in body movements like these, speak with your healthcare provider.

6. Heart rhythm changes

Austedo can cause or contribute to an irregular heartbeat, also known as QT prolongation. This is especially true at doses that are higher than recommended. Symptoms of QT prolongation can include lightheadedness, palpitations, and feeling faint. But many people don’t have symptoms at all.

It’s important to speak with your healthcare provider about any existing heart conditions you have prior to starting Austedo. And while you’re taking Austedo, your healthcare provider may monitor your heart rhythm regularly — especially if you have any heart-related risk factors. Uncontrolled QT prolongation can lead to more serious health issues.

Good to know: If you have a history of irregular heartbeats, or take other medications that affect your heart rhythm, you have a higher risk of developing QT prolongation. People with a history of long QT interval or arrhythmias should avoid taking Austedo.

7. Depression and suicidal thoughts

Depression and suicidal thoughts are relatively common among people with Huntington’s disease. Taking Austedo may increase the risk of developing these feelings. The medication has a boxed warning for this risk, the FDA’s most serious medication warning.

Depression can sometimes be hard to spot — especially in the early days. But if you’re feeling hopeless, having trouble concentrating, or are becoming less engaged in your day-to-day activities, know that you’re not alone. It’s important to watch for these signs and symptoms and reach out to your family or close friends for support.

If you suspect you may have depression, or start having thoughts of self-harm, talk to your healthcare provider right away. The two of you can discuss risks and benefits of your treatment plan. You can also call or text the Suicide and Crisis Lifeline at 988 anytime. It’s free and confidential.

When to contact a healthcare provider about Austedo side effects

Many of Austedo’s common side effects should improve over time as your body gets used to the medication. But if you have severe side effects or they don’t seem to get better with time, contact your healthcare provider.

Some symptoms may indicate a more serious Austedo side effect. Austedo has been linked to a rare but life-threatening condition called neuroleptic malignant syndrome. Possible symptoms include:

• High fever

• Increased sweating

• Stiff muscles

• Confusion

• Fast or irregular heartbeat

If you experience any symptoms like these while taking Austedo, call 911 or go to the nearest emergency room.

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Written by:

Nidhi Gandhi-Patel, PharmD, BS

Nidhi Gandhi-Patel, PharmD, is a licensed pharmacist in Illinois. She has worked in the pharmacy profession for more than 6 years and currently is the interim Co-Director of the AACP Transformation Center at the American Association of Colleges of Pharmacy (AACP).

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.