llan Melnick, MD; and Linda Trinh, DNP, discuss how to recognize subtle schizophrenia symptoms through systematic patient engagement, explore the novel mechanism of action and clinical benefits of xanomeline/trospium chloride as a first-in-class muscarinic receptor agonist for treating all three symptom domains of schizophrenia, and share practical strategies for switching patients from traditional antipsychotics while managing side effects and setting appropriate expectations.
EP. 1: Recognizing Schizophrenia Symptoms and Diagnosis
July 28th 2025Panelists discuss how clinicians can better identify subtle and unreported schizophrenia symptoms through systematic evaluation of positive symptoms, negative symptoms, cognitive deficits, and functional impairment, which often requires input from family members and caregivers.
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EP. 2: A Case of a 24-Year-Old Man With Schizophrenia
July 28th 2025Panelists discuss how Jacob’s case demonstrates the importance of recognizing negative symptoms that preceded positive symptoms by nearly a year, and how a partial response to risperidone with continued breakthrough symptoms and cognitive “fogginess” indicates the need for treatment optimization.
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EP. 3: Xanomeline/Trospium Chloride for Treatment of Schizophrenia
August 4th 2025Panelists discuss how xanomeline/trospium chloride represents a first-in-class medication with a novel muscarinic mechanism that addresses positive, negative, and cognitive symptoms while avoiding typical antipsychotic adverse effects such as movement disorders and prolactin elevation.
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EP. 4: Efficacy and Safety of Xanomeline/Trospium Chloride and Experience in Treating Schizophrenia
August 4th 2025Panelists discuss how real-world experience with xanomeline/trospium chloride shows efficacy across all 3 symptom domains with manageable gastrointestinal adverse effects that typically resolve within 2 weeks, requiring slow titration and patient education about empty stomach dosing.
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EP. 5: Recommendations for Switching to Xanomeline/Trospium Chloride for Patients With Schizophrenia
August 11th 2025Panelists discuss how switching patients to xanomeline/trospium chloride requires different cross-titration strategies depending on whether patients are on “done” medications versus “pines” medications, with special attention to anticholinergic effects when transitioning from sedating antipsychotics.
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EP. 6: Evolving Schizophrenia Treatment Paradigm
August 11th 2025Panelists discuss how xanomeline/trospium chloride should be positioned as a first-line treatment option rather than waiting for treatment failures, given its superior effect size, comprehensive symptom coverage, and favorable tolerability profile compared with that of traditional antipsychotics.
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EP. 7: A Case of a 52-Year-Old Female Patient With Schizophrenia
August 18th 2025Panelists discuss how Lila’s late-onset schizophrenia at age 52 raises diagnostic concerns requiring thorough medical workup, and how her response to olanzapine with sedation and shakiness suggests the need for dose reduction or consideration of alternative treatments such as xanomeline/trospium chloride.
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EP. 8: Best Practices for Schizophrenia Management
August 18th 2025Panelists discuss how best practices involve starting with lower doses in older patients, considering long-term tolerability over acute symptom control, and potentially using xanomeline/trospium chloride as first-line treatment even for treatment-naive patients presenting with acute psychosis.
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