Observational analysis shows neutropenia risk with antipsychotic xanomeline-trospium, highlighting its unique mechanism on dopamine release.
Xanomeline‐trospium (Cobenfy®) is a new antipsychotic with a mechanism of action different from that of currently available typical and atypical antipsychotics. Instead of blocking dopamine D‐2 receptors, xanomeline‐trospium acts as an agonist at muscarinic M1/M4 receptors, resulting in decreased dopamine release in psychosis‐implicated regions of the brain. The trospium component of the combination serves as a selective muscarinic antagonist in the periphery, thereby alleviating xanomeline‐mediated cholinergic effects.
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Y. W. Francis Lam (2025) studied this question.
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