REVIEW ON KARXT: MUSCARINIC RECEPTOR MODULATION AS A NEW STRATEGY IN SCHIZOPHRENIA TREATMENT

Mayur A. Pawar*, Naziya A. Tamboli, Shaunak A. Bele, Shantanu A. Bele, Vaibhav P. Khadul, Amit A. Pawar, Priti M. Gurav, Samarth A. Khadatare

Schizophrenia is a complex mental health condition that typically emerges in late adolescence or early adulthood, leading to significant challenges in various aspects of life. The dopamine hypothesis has been a key framework for understanding the physiology of schizophrenia, but the exact causes remain somewhat elusive. Recently, a new treatment called KarXT has been introduced for managing schizophrenia. This innovative drug combines Xanomeline, which selectively targets the M1 and M4 muscarinic receptors, with Trospium, a non-selective anti-muscarinic agent. One of the great things about Xanomeline is that it easily crosses the blood-brain barrier (BBB), which means it has the potential to alleviate both positive and negative symptoms of the disorder. On the other hand, Trospium does not cross the BBB, so it does not interact with those receptors; instead, it works to reduce activity in peripheral muscarinic receptors. Encouragingly, ongoing clinical trials assessing the effectiveness of KarXT in treating schizophrenia have reported positive results, including better PANSS scores and enhanced cognitive function compared to a placebo. These findings suggest that KarXT can provide symptom relief without the side effects often linked to Xanomeline when used alone, which have been a concern with other schizophrenia treatments.