In this episode, I break down one of the most interesting new developments in schizophrenia treatment: a medication that treats psychosis without dopamine blockade. And it also works for negative symptoms.

I’m talking about xanomeline–trospium, brand name Cobenfy, a muscarinic-based therapy that targets M1 and M4 receptors, avoids extrapyramidal symptoms and metabolic side effects, and is not technically classified as an antipsychotic by the FDA. I walk through the mechanism, the EMERGENT trial data, efficacy for both positive and negative symptoms, side effect profile, dosing pearls, and where this might fit clinically.

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