KarXTa drug recently approved for the treatment of schizophrenia is raising high expectations regarding its potential to also treat Alzheimer’s disease. This drug represents a significant advance in psychiatry, as it targets muscarinic receptors in the brain, allowing it to have both antipsychotic and cognitive effects.
This innovation has relaunched research in muscarinic drugsa class of drugs that had taken a backseat in the treatment of brain disorders.
KarXT’s development began with research into xanomeline, a compound that, in the 1990s, was shown to reduce psychotic symptoms in people with Alzheimer’s. However, xanomeline has caused side effects such as nausea and vomiting due to its action on muscarinic receptors throughout the body. To avoid these effects, the company Karuna Therapy combined xanomeline with trospium, a compound that blocks these receptors outside the brain, minimizing side effects in the body.
This approach, known as KarXT, has been shown to offer antipsychotic and cognitive benefits in patients with schizophrenia, with fewer adverse effects than the original treatment, reports an article in ‘Nature‘.
The approval of this drug in the USA meant, for Eduard Vieta, researcher at the Biomedical Research Center in Mental Health Network (CIBERSAM). Head of Psychiatry and Psychology Service of the Clinical Hospital of Barcelona and professor at the University of Barcelona«an important advance in the treatment of schizophrenia, since it is the first drug that does not act directly on dopamine receptors, but on muscarinic ones. In the statements a Scientific multimedia centerVieta stated that this sense, although acetylcholine and dopamine are interconnected, involves a very relevant innovation since it represents a mechanism of action compared to current drugs and a different adverse effect profile, which may constitute a good alternative for patients who cannot tolerate the drugs currently used.
Furthermore, the magnitude of the effect in the acute phase and the results of the extension study on long-term safety and efficacy are also positive. After its approval, clinical experience will demonstrate how much it represented a real progress for clinical practice in this pathology so in need of new approaches.
The success of KarXT has renewed interest in muscarinic drugswhich are known to influence cognition and reward circuits in the brain. The researchers noted that the drug could have applications beyond schizophrenia, particularly in treating psychosis associated with Alzheimer’s disease and disorders such as bipolar.
Additionally, M1 muscarinic receptors, linked to cognition, are being studied to treat cognitive impairment in Alzheimer’s patients. It is hoped that drugs that target these receptors can slow the progression of the neurodegenerative disease.
Despite the excitement surrounding KarXT, researchers warn that developing new drugs is a long and challenging process.
Thus, for José García-Valdecasas, deputy secretary of the Board of directors of the Spanish Association of Neuropsychiatry“a new drug comes out with a new mechanism of action, which in principle is fine, but in these cases we must avoid giving an image of excessive effectiveness or excessive hope in the face of the novelty. Just because something is new doesn’t necessarily mean it’s better.. “We need to focus on the studies and data available.”
The same as the placebo
For example, a recent clinical study on the drug like hemraclisanother muscarinic drug for schizophrenia, failed to outperform placebo, raising questions about the effectiveness of other similar drugs. Scientists are studying allosteric modulators, which more specifically affect muscarinic receptors, with the aim of reducing side effects and improving efficacy.
The future of KarXT and other muscarinic drugs remains uncertain. While clinical trials have shown promising results, the true test of these drugs will be their performance in the field real worldwhere patients are not isolated in controlled environments. Researchers continue to observe the effects of KarXT in outpatients with schizophrenia and are also studying its impact on Alzheimer’s disease.
Although the development of these treatments is still in the early stages, advances in the use of muscarinic drugs to treat brain disorders offer new hope in treating complex diseases such as schizophrenia and Alzheimer’s.
However, the Scientists highlight the need for further research understand how these drugs affect patients in the long term and whether they can actually slow or stop the progression of diseases such as Alzheimer’s.
What are the key benefits of KarXT compared to traditional schizophrenia treatments?
Interview Between Time.news Editor and Dr. Eduard Vieta, Expert in Psychiatry
Time.news Editor: Good afternoon, Dr. Vieta! Thank you for joining us today. We’re eager to discuss the recent approval of KarXT for the treatment of schizophrenia. How significant is this breakthrough from your perspective?
Dr. Eduard Vieta: Good afternoon! It’s a pleasure to be here. The approval of KarXT is indeed a significant advancement in psychiatry. It’s the first drug that targets muscarinic receptors rather than the traditional dopamine receptors. This shift in focus is crucial because it opens up new avenues for treatment, especially for patients who haven’t responded well to existing medications.
Time.news Editor: That’s fascinating! Could you elaborate on how KarXT works and its potential beyond schizophrenia?
Dr. Vieta: Certainly! KarXT combines xanomeline — which was previously shown to have effects on psychotic symptoms in Alzheimer’s patients — with trospium, which blocks receptors outside the brain. This clever combination allows it to minimize side effects like nausea while still providing antipsychotic and cognitive benefits. The real excitement lies in its dual function, suggesting it may also be effective in treating psychosis related to Alzheimer’s disease and even bipolar disorder.
Time.news Editor: It sounds like KarXT could be a game-changer. You mentioned that it has fewer adverse effects than traditional treatments. Why is this important for patients?
Dr. Vieta: Side effects are a major concern in psychiatric medications. Many patients either don’t tolerate these drugs or experience significant discomfort while on them. KarXT’s different mechanism of action offers a promising alternative, potentially allowing more patients to find effective treatment without being sidelined by unpleasant reactions.
Time.news Editor: What does the research say about its efficacy in the long term? Are there specific studies validating its performance?
Dr. Vieta: Yes, the initial studies show a positive safety and efficacy profile for KarXT. Follow-up studies have demonstrated meaningful effects during acute phases of treatment. Still, it’s crucial to remember that clinical experience after approval will give us more insights into how it performs over time in a real-world setting.
Time.news Editor: Now that KarXT is on the market, how do you see it influencing future drug development, particularly in the realm of muscarinic drugs?
Dr. Vieta: The success of KarXT has indeed reignited interest in muscarinic drugs. Research in this area had waned over the years, but KarXT’s approval could pave the way for further exploration into how these drugs influence cognition and emotions. We hope to see more developments targeting M1 muscarinic receptors, which could help with cognitive impairment in Alzheimer’s patients.
Time.news Editor: While there’s excitement surrounding KarXT, it seems there are also cautions regarding its development. What should the public keep in mind as new drugs emerge?
Dr. Vieta: That’s a very important point. While innovations like KarXT are exciting, we must temper expectations. Drug development is inherently complex and lengthy. Just because a drug is new doesn’t guarantee it will outperform existing treatments universally. We need thorough assessments and real-world data to understand its full impact.
Time.news Editor: Thank you for that perspective, Dr. Vieta. As we wrap up, is there a message you’d like to convey to patients or caregivers considering KarXT?
Dr. Vieta: Yes, I would encourage patients and caregivers to have open discussions with their healthcare providers about the potential benefits and risks of KarXT. It’s essential to stay informed and approach any new treatment with an understanding of individual health needs and existing medical conditions. The future of psychiatric treatment is promising, but informed choices remain vital.
Time.news Editor: Thank you so much for your insights today, Dr. Vieta. We’re looking forward to seeing how KarXT and other muscarinic drugs evolve in the coming years!
Dr. Vieta: Thank you for having me! It’s been a pleasure.