By Zohar Ben Simon, Staff Writer
For a long time, schizophrenic patients have had to live with mediocre medications to treat their symptoms. Since there were no specific drugs that effectively treated their schizophrenia, they had to learn to cope with their suffering. However, the new FDA approved drug, KarXT, has the potential to change their lives.
The drug’s objective is to target symptoms of schizophrenia, such as hallucinations, delusional or irrational thinking, and suspicion of others. In previous years, schizophrenia treatment was mainly focused on antipsychotics, cognitive behavioral therapy (CBT), social support and counseling. However, these remedies were not always optimal.
Although counseling and therapy have benefits for schizophrenia patients, including coping mechanisms, improving social skills and reduction of relapse rates, they are not consistently efficient. Some patients have symptoms like disorganized thinking and lack of motivation, which can make it difficult for them to engage in or routinely attend their therapy sessions without the proper social support.
Antipsychotics are used to reduce the amount of dopamine in patients’ brains, which leads to less hallucinations and delusions, but they have unwanted side effects such as dizziness, weight gain, high cholesterol and blood sugar and abnormal movements.. In the 1990’s, researchers wanted to control dopamine production in attempts to reduce psychotic symptoms seen with patients of Alzheimer’s disease and used xanomeline as an active component in the medication. Xanomeline activates the muscarinic receptors, which are located on dopamine neurons and can influence dopamine release. However, when put to the test in a clinical trial, participants who took the newly developed drug got side effects such as nausea and vomiting due to the large presence of muscarinic receptors in the body. The participants ceased to take the medication, causing the drug to be abandoned.
In 2009, a biopharmaceutical company called Karuna Therapeutics, now owned by Bristol Myers Squibb, picked the drug backup and found a new approach. They decided to combine xanomeline with trospium chloride, a muscarinic receptor blocker, which successfully prevented unwanted side effects that were previously prevalent in the patients. The combination of these two components was labeled KarXT.
A five-week U.S. clinical trial for KarXT proved its effectiveness, as it tested patients from the ages of 18-65 years old that were diagnosed with schizophrenia and whose psychosis had called for hospital admission. From December of 2020 to April of 2022, 252 participants that met the requirements were randomly assigned to KarXT or a placebo. The results favored KarXT over the placebo, and the trial proved that this new medication was effective in reducing positive and negative symptoms of schizophrenia, without causing side effects.
On September 26, 2024, KarXT was approved by the FDA and renamed Cobenfy. While its main goal is to treat the symptoms of schizophrenia, some researchers believe that it could possibly treat other diseases such as Alzheimer’s or Parkinson’s disease. M1 receptors, a type of muscarinic receptor, have a crucial role in cognitive functions. A drug that targets M1 receptors could potentially reduce cognitive decline. A clinical trial using mice with an M1-specific drug was said to have slowed down neurodegeneration in mice with a disease resembling Alzheimer’s in humans. However, other trials show that using M1 receptors also led to unwanted side effects, which contradict the effectiveness of this idea and call for further research to be conducted.
Cobenfy has the power to change the lives of those who suffer from schizophrenia. Its establishment is a significant step in improving the antipsychotic medications previously offered to schizophrenia patients, which often cause unfortunate side effects. Although further research is needed, animal testing suggests that Cobenfy could be the key to aiding patients struggling with neurodegenerative diseases such as Alzheimer’s and Parkinson’s.