KarXT (Cobenfy): The Antipsychotic that Could Be a Game Changer

KarXT, brand name Cobenfy, is the newest antipsychotic medication on the market and is a combination of xanomeline and trospium chloride. It uses a different mechanism of action than what we are used to, targeting muscarinic receptors instead of dopaminergic ones. So today, join me as I talk about how we think KarXT works, the studies that got us to where we are today, and then end on my opinions on taking it as someone with a schizophrenia spectrum illness called schizoaffective disorder.

Enjoy :)

Sources used in this video (and a few other good things to take a look at):


ARTICLES/PODCASTS:

The FDA’s Piece on it: https://www.fda.gov/news-events/press...

An article in TIME: https://time.com/7024352/fda-approves...

A short podcast episode about it: https://www.thecarlatreport.com/blogs...


JOURNAL ARTICLES (Including the available results from the EMERGENT Trials):

Azargoonjahromi A. (2024). Current Findings and Potential Mechanisms of KarXT (Xanomeline-Trospium) in Schizophrenia Treatment. Clinical drug investigation, 44(7), 471–493. https://doi.org/10.1007/s40261-024-01...

Bodick, N. C., Offen, W. W., Levey, A. I., Cutler, N. R., Gauthier, S. G., Satlin, A., Shannon, H. E., Tollefson, G. D., Rasmussen, K., Bymaster, F. P., Hurley, D. J., Potter, W. Z., & Paul, S. M. (1997). Effects of xanomeline, a selective muscarinic receptor agonist, on cognitive function and behavioral symptoms in Alzheimer disease. Archives of neurology, 54(4), 465–473. https://doi.org/10.1001/archneur.1997...

Kaul, I., Sawchak, S., Correll, C. U., Kakar, R., Breier, A., Zhu, H., Miller, A. C., Paul, S. M., & Brannan, S. K. (2024). Efficacy and safety of the muscarinic receptor agonist KarXT (xanomeline-trospium) in schizophrenia (EMERGENT-2) in the USA: results from a randomised, double-blind, placebo-controlled, flexible-dose phase 3 trial. Lancet (London, England), 403(10422), 160–170. https://doi.org/10.1016/S0140-6736(23...

Kaul, I., Sawchak, S., Walling, D. P., Tamminga, C. A., Breier, A., Zhu, H., Miller, A. C., Paul, S. M., & Brannan, S. K. (2024). Efficacy and Safety of Xanomeline-Trospium Chloride in Schizophrenia: A Randomized Clinical Trial. JAMA psychiatry, 81(8), 749–756. https://doi.org/10.1001/jamapsychiatr...

Paul, S. M., Yohn, S. E., Popiolek, M., Miller, A. C., & Felder, C. C. (2022). Muscarinic Acetylcholine Receptor Agonists as Novel Treatments for Schizophrenia. The American journal of psychiatry, 179(9), 611–627. https://doi.org/10.1176/appi.ajp.2110...

Shekhar, A., Potter, W. Z., Lightfoot, J., Lienemann, J., Dubé, S., Mallinckrodt, C., Bymaster, F. P., McKinzie, D. L., & Felder, C. C. (2008). Selective muscarinic receptor agonist xanomeline as a novel treatment approach for schizophrenia. The American journal of psychiatry, 165(8), 1033–1039. https://doi.org/10.1176/appi.ajp.2008...

Yohn, S. E., Weiden, P. J., Felder, C. C., & Stahl, S. M. (2022). Muscarinic acetylcholine receptors for psychotic disorders: bench-side to clinic. Trends in pharmacological sciences, 43(12), 1098–1112. https://doi.org/10.1016/j.tips.2022.0...


CLINICAL TRIAL INFO (In case you want to dive a little deeper or keep up with the ongoing trials):

EMERGENT-1: https://clinicaltrials.gov/study/NCT0...

EMERGENT-2: https://clinicaltrials.gov/study/NCT0...

EMERGENT-3: https://clinicaltrials.gov/study/NCT0...

EMERGENT-4: https://clinicaltrials.gov/study/NCT0...

EMERGENT-5: https://clinicaltrials.gov/study/NCT0...

ARISE: https://clinicaltrials.gov/study/NCT0...


Phew, that’s a lot, happy reading!


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Disclaimer: I am not a qualified mental health professional. This channel exists for educational purposes, and I do my best to provide accurate and up-to-date information. In order to create content, I combine scientific resources (peer reviewed studies and easy-to-understand articles) and my own personal experiences/advice. I seek to make complicated topics easy to understand, but I am no substitute for a doctor, therapist, or other qualified mental health professional.

#schizophrenia #antipsychotics #psychiatricmedications #karxt #cobenfy #schizoaffective #schizoaffectivedisorder #mentalhealthawareness