Embracing New Therapies in Schizophrenia Management: Introductions

On September 26, 2024, the US Food and Drug Administration (FDA) approved xanomeline and tropism chloride capsules (Cobenfy), backed by evidence in phase 3 EMERGENT trials. The approval marks the start of a new era in the management of schizophrenia, as the agent, formerly known as KarXT, marks the first new pharmacological approach to treating schizophrenia since the 1970s.

Xanomeline and tropism chloride capsules act as a dual M1/M4 muscarinic acetylcholine receptor agonist in the central nervous system. Unlike previous schizophrenia treatments, this drug does not directly regulate the dopamine receptor—only indirectly modulates.

To commemorate and offer perspective on what this approval means for the healthcare community, HCPLive Psychiatry hosted a Special Report where leading subject matter experts discussed the approval of xanomeline and tropism chloride capsule for schizophrenia. In this opening segment, moderator Sam Clark, MD, PhD, introduces panelists Rishi Kakar, MD, lead investigator of the EMERGENT trials, and Andrew J. Cutler, MD. The remainder of this panel discussion, which can be found below, focused not only on the approval of xanomeline and tropism chloride capsules but also on the latest updates and the most pressing unmet needs in schizophrenia management.

Series Segments:

• Introductions
• Mechanism of Action of Xanomeline and Trospium Chloride Capsules
• Applying EMERGENT Trial Results to Real-World Clinical Practice for Schizophrenia
• Balancing the Benefits and Risks of Xanomeline and Trospium Chloride Capsules
• Unmet Needs, Future Research in Schizophrenia and Muscarinic Agonists

Subject Matter Experts

• Sam Clark, MD, PhD, (Moderator) is a former practicing psychiatrist and is the founder and chief executive officer of Terran Biosciences.
• Andrew Cutler, MD, is a clinical associate professor in the Department of Psychiatry and Behavioral Sciences at SUNY Upstate Medical University and the chief medical officer of the Neuroscience Education Institute.
• Rishi Kakar, MD, is a psychiatrist based out of southern Florida as well as the medical director and chief scientific officer of Segal Trials. Kakar served as the principal investigator on the pivotal EMERGENT trials.

Relevant disclosures for Cutler include Karuna, Bristol Myers Squibb, and others. Relevant disclosures for Kakar include Karuna, Bristol Myers Squibb, and others. Relevant disclosures for Clark include Terran Biosciences.