Xanomeline/trospium chloride (COBENFY™), a first-in-class, oral, fixed-dose muscarinic agonist/antagonist combination, has been approved in the USA on September 26, 2024, for the treatment of schizophrenia in adults. This approval marks a significant advancement in the treatment landscape for schizophrenia, offering a novel mechanism of action and a strategy to manage potential side effects.
The drug combines xanomeline, a muscarinic receptor agonist, with trospium chloride, a peripheral anticholinergic agent. Xanomeline is believed to exert its therapeutic effects by acting as an agonist at M1 and M4 muscarinic acetylcholine receptors in the brain. These receptors play a crucial role in cognitive function and neuronal excitability, making them promising targets for schizophrenia treatment.
Trospium chloride is included in the formulation to reduce the peripheral cholinergic adverse events associated with xanomeline. By selectively blocking muscarinic receptors in the periphery, trospium chloride aims to minimize side effects such as gastrointestinal disturbances and excessive salivation, thereby improving patient tolerability and adherence to treatment.
The approval of xanomeline/trospium chloride represents a significant milestone in the development of new treatments for schizophrenia. It addresses the need for medications with novel mechanisms of action and improved side effect profiles, potentially offering a better quality of life for individuals living with this chronic mental illness.
