Balancing the humors: an opinionated take on NEJM highlights for March 2021
Marc Herant
March 30, 2021
A new approach to schizophrenia Antipsychotic agents treat schizophrenia by manipulating the dopaminergic system. While they are effective at treating psychosis, they can have major side effects and they lack the ability to address so called negative symptoms e.g. apathy, lack of social connection, poverty of thought. Enter the muscarinic cholinergic system which is tricky to manipulate in the CNS without untoward systemic effects as Lilly found out with their M1/4 agonist xanomeline. Karuna Therapeutics has now licensed the molecule and cleverly combined with it with trospium, an antagonist with