Current antipsychotic medications block dopamine receptors to help manage hallucinations, delusions, and other symptoms of schizophrenia.
Cobenfy targets a different neurotransmitter to indirectly influence dopamine levels.
Previously called KarXT, Cobenfy is taken twice daily as a pill.
Illustration by Zoe Hansen for Verywell Health
Historically, medicines approved to treat schizophrenia have relied on the same primary pathways in the brain.
By leveraging a novel pathway, Cobenfy offers a new option to manage this challenging condition.
How Does Cobenfy Work?
Unlike current antipsychotic medications, xanomeline doesnt bind directly to dopamine receptors.
It instead targets the M1 and M4 muscarinic receptors in the central nervous system.
Overall, those side effects are much more mild than many years ago when we used xanomeline alone.
Its now tolerable to a patient, Fan said.
In clinical trials, Cobenfy was shown to minimize both positive and negative symptoms.
It also appeared to improve cognitive outcomes, Fan noted.
There was no difference in weight gain or treatment discontinuation between Cobenfy and a placebo.
Currently, the drug clozapine is the only option for treatment-resistant schizophrenia.
Fan said Cobenfy could be considered before using clozapine for treatment-resistant patients.
How Well Does Cobenfy Work in the Long Run?
There are just three published placebo-controlled studies, each lasting only five weeks.
Some analysts say the short duration of clinical trials leaves questions about the drugs long-term efficacy.
In April, BMS shared topline results from two open-label trials that lasted up to a year.
The company said participants in those trials didnt have any serious metabolic side effects or develop motor problems.
This is a very promising medication in many ways, Fan said.
The company said that the price is in line with other antipsychotic schizophrenia medications.
It said the drug may also be useful as a treatment for Bipolar I disorder and Alzheimers disease agitation.
Talk to your healthcare provider to see if this medication might be appropriate for your situation.
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