Southern California Psychiatry: Review of New Agents in Schizophrenia and Dementia

Toward a Muscarinic Agent Solution for the Presynaptic Dopamine Problem in Schizophrenia

Research on Cobenfy (xanomeline-trospium) presents a novel approach to management of schizophrenia by targeting muscarinic acetylcholine receptors. By avoiding dopamine receptor blocking, this drug reduces risk of tardive dyskinesia and other adverse motor effects. Gus Alva, MD, Jonathan Meyer, and Chelsie Monroe, APN, presented findings on this new medication. Read about the presentation here.

Treatment-Resistant Depression and Well-Rounded Care, With Alejandro Alva at Southern California Psychiatry

Alejandro Alva, MD, discussed the various techniques to treat depression and considering all available treatment modalities. Treatments like transcranial magnetic stimulation, vagal nerve stimulation, ketamine, and esketamine, can be choices for patients with treatment resistant depression. Alva pointed out that clinicians should also be sure to address psychosocial aspects of depression to ensure well-rounded care. Watch the full video interview here.

Addressing Agitation in Dementia: Emerging Options and Clinical Considerations

Discussing agitation in dementia, Gerald Maguire, MD, noted that the landscape is beginning to shift. With Rexulti (brexpiprazole) approval for agitation in dementia, new pharmacological options are available to these patients. However, he noted, prompt intervention and addressing lifestyle factors is also essential. View the full interview here.

Clinician Tips in Prescribing New Xanomeline-Trospium for Schizophrenia

Returning to discussion of Cobenfy, Chelsie Monroe, MSN, APN, PMHNP-BC, expressed enthusiasm for this treatment’s potential in treatment resistant schizophrenia. When transitioning patients who may already be taking clozapine, clinicians should be careful about destabilization and consider thoroughly whether this muscarinic agent is a good fit. This new treatment option represents a new mechanism of action, Monroe pointed out, avoiding many of the adverse effects often seen in traditional antipsychotics. See the full video interview here.