Schizophrenia affects about 1 in 300 people worldwide and is associated with a range of troubling symptoms, including persistent delusions and hallucinations, disorganized thinking and extreme agitation. Mental health care professionals find this condition hard to treat for several reasons, with severe side effects from commonly prescribed medications being a significant barrier. One promising new schizophrenia drug, Cobenfy, is formulated to reduce the severity of side effects while controlling symptoms.
Overview of Cobenfy and Its Intended Use
Schizophrenia can be profoundly disruptive to daily life. Currently, there’s no cure, but a new medicine for schizophrenia called Cobenfy can provide relief from symptoms and reduce the overall severity of this disorder.
Introduction to Cobenfy
Traditional schizophrenia medications block the body’s dopamine receptors and often cause severe side effects such as weight gain, movement disorders and metabolic issues. Cobenfy works differently because it targets the cholinergic receptors instead of the dopamine receptors. The cholinergic receptors play an important role in many bodily functions, including heart rate, muscle movement, digestion and cognitive functions such as learning and memory.
Cobenfy, also known as KarXT, was originally developed by Eli Lilly in the mid-1990s as a possible treatment for Alzheimer’s disease. It initially showed promise in improving memory and reducing psychotic symptoms, but it was ultimately discontinued because it was poorly tolerated. Years later, researchers found that one of the drug’s active ingredients could be effective in treating schizophrenia by targeting specific cholinergic receptors.
Researchers were still concerned about the medication’s side effects, so trospium chloride was added to the formulation. This blocked side effects such as nausea and dry mouth without changing how the medication affected the brain.
Because Cobenfy is a new class of drug with less serious side effects, it doesn’t carry a black box warning. The Food and Drug Administration approved this drug for the treatment of psychiatric disorders on September 26, 2024, based on the EMERGENT clinical program, which included two open-label trials and three placebo-controlled trials.
Target Population
Adults with schizophrenia make up the target population for Cobenfy, as the drug hasn’t yet been tested and proven safe in children. Because medications can affect children differently, further studies would be needed to determine whether this is a viable treatment for those under age 18.
How Cobenfy Works in Treating Schizophrenia
Cobenfy is a new class of drug that addresses schizophrenia differently than traditional options.
Mechanism of Action
Cobenfy works by targeting the brain’s muscarinic acetylcholine receptors, which are types of cholinergic receptors. The drug has two main ingredients, including xanomeline and trospium chloride.
Xanomeline is a muscarinic agonist, meaning that it activates the muscarinic receptors. It targets the M1 and M4 receptors, which control cognitive processes, motivation, reward perception and decision-making.
The second active ingredient, trospium chloride, blocks the receptors outside the brain. This cuts down on the likelihood of the individual experiencing severe symptoms.
By contrast, traditional antipsychotics target dopamine receptors, reducing dopamine overactivity to control schizophrenia symptoms. While this can successfully manage symptoms such as delusions and hallucinations, it comes with serious side effects such as movement disorders and metabolic issues.
Dosing and Administration
Cobenfy comes in two forms, including capsules and coated pellets designed for oral administration. Generally speaking, patients start at a dose of one 50 mg/20 mg capsule (this indicates 50 mg of xanomeline and 20 mg of trospium chloride), two times daily. They stay at this starting dose for at least two days before increasing to a 100 mg/20 mg capsule twice daily. They stay at this dose for at least five days. From there, their doctor can increase their dose up to the maximum dose of 125 mg/30 mg twice daily.
Doctors typically recommend that their patients take Cobenfy at least an hour before or two hours after a meal. The capsules should be swallowed whole without breaking or emptying.
Potential Benefits and Common Side Effects
Cobenfy effectively controls symptoms of schizophrenia, improving individuals’ quality of life and helping them better maintain relationships, achieve personal goals and integrate into their communities. While individuals taking this medication typically don’t experience the severity of side effects other schizophrenia medications bring, there are still some considerations to take into account before beginning this drug.
Benefits of Cobenfy
While researchers are still evaluating Cobenfy’s long-term efficacy, clinical trials show a lot of promise. Participants in these studies experienced a significant reduction in their symptoms compared to those taking placebos. This includes a reduction in positive symptoms such as delusions and hallucinations, as well as negative symptoms such as a lack of motivation, decreased speech and reduced emotional expression.
Current studies indicate that patients who stay on Cobenfy for an extended period report better social interactions, improved confidence and an overall improvement in their sense of well-being. In other words, not only does Cobenfy reduce their symptoms, but it helps to enhance their quality of life.
Common Side Effects
Cobenfy brings fewer, less severe side effects than traditional medications, and it’s generally well-tolerated. However, like most medications, it’s associated with several side effects, including:
- Nausea
- Indigestion
- Constipation
- Vomiting
- High blood pressure
- Abdominal pain
- Diarrhea
- Increased heart rate
- Dizziness
- Upset stomach
In addition to these common side effects, taking Cobenfy may cause serious side effects such as:
- Problems with emptying the bladder
- Liver impairment
- Gallbladder problems
- Slow emptying of the stomach
- Narrow-angle glaucoma
- Allergic reactions
- Problems with the central nervous system
Until someone knows how Cobenfy will affect them, they shouldn’t drive or operate heavy machinery. If they experience severe symptoms, they should immediately talk to their doctor.
Important Considerations for Patients and Caregivers
Cobenfy can provide life-changing results for someone with schizophrenia. To get the most from this medication, individuals should make sure they see their doctor regularly, incorporate this drug as part of a healthy lifestyle and connect with supportive resources.
Monitoring and Follow-up
Individuals taking Cobenfy should see their doctor on a regular basis. In most cases, doctors prefer to see their patients every three to six months, depending on the scope and severity of their symptoms and medication side effects. These check-ups give the doctor the chance to see how the individual responds to the medication and to make adjustments to the dosage.
During these appointments, the health care provider may assess improvements in the individual’s symptoms and monitor for side effects. They may also perform a routine health check, including recording the individual’s blood pressure and heart rate, and they may ask about adverse reactions to the medication.
Lifestyle and Support
Individuals need to take Cobenfy regularly to gain the most benefits from the medication. For many, integrating the medication into daily routines helps them stay consistent. For example, it may be helpful to keep the medication on a nightstand and take it first thing in the morning, at least an hour before their first meal of the day, and in the evening, at least two hours after their evening meal.
Several resources help those taking Cobenfy, helping them understand the medication, navigate side effects and connect with mental health services. The Cobenfy Cares Patient Support Program is available to everyone who takes the medication. This program provides personalized support and has advisors who can answer questions about the medication.
Additionally, the Cobenfy website offers a wealth of information about the drug, including a more in-depth look at how the medication works and what serious side effects to watch for. Finally, individuals may find support through local support groups as well as mental health services, including therapists who provide one-on-one counseling and practical advice.
Legal and Ethical Considerations
Before starting on Cobenfy, patients should be fully informed about the potential benefits and risks of the medication, including long-term risks such as hypertension. While this medication isn’t considered addictive and doesn’t have a potential for abuse, it’s important only to take it as a health care provider orders.
Schizophrenia is a poorly understood condition surrounded by misconceptions, which can be a barrier to care for those living with this illness. By educating the public and promoting awareness, we can break down these barriers and promote access to life-changing medications such as Cobenfy for those who need it.
If you or someone you love is living with a treatable condition such as schizophrenia, help is available. The compassionate professionals at Restore are here to provide support and effective treatment. Contact us today to learn more.
