Tetrabenazine racemate is primarily used in the treatment of hyperkinetic movement disorders, particularly Huntington's disease. It works by depleting monoamines such as dopamine, serotonin, and norepinephrine in the central nervous system, which helps to reduce involuntary movements (chorea) associated with the condition. It is also employed off-label to manage other movement disorders, including tardive dyskinesia and Tourette syndrome. Additionally, it has shown efficacy in addressing certain psychiatric symptoms like agitation and aggression in patients with neurodegenerative diseases. The racemic form allows for a balanced pharmacological profile, ensuring both efficacy and tolerability in clinical use. Use under close medical supervision is recommended due to potential side effects such as depression or drowsiness.