{"title":"Xanomeline/Trospium Combination for Schizophrenia: Treatment Considerations for Older Adults.","authors":"Clayton English, Kaela Bergeron, Leigh Ann Mike","doi":"10.3928/00989134-20250509-03","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Xanomeline/trospium, a combination of a mixed muscarinic agonist/peripheral antagonist, is a novel treatment for schizophrenia that does not antagonize dopamine receptors. Given its unique pharmacology on the cholinergic system, special considerations may apply for older adults.</p><p><strong>Method: </strong>The current article reviews the evidence of xanomeline/trospium in older adults as well as implications and considerations for use in practice.</p><p><strong>Results: </strong>The evidence of using xanomeline/trospium is largely derived from the phase-3 EMERGENT clinical trial program, which investigated safety and efficacy in adults aged 18 to 65 years with schizophrenia. Significant reduction in psychosis was demonstrated; however, gastrointestinal effects were common.</p><p><strong>Conclusion: </strong>Xanomeline/trospium is a novel treatment for schizophrenia that lacks many of the adverse effects associated with dopamine receptor blockers. Although the package insert provides guidance for use in older adults, patients aged >65 years were excluded from EMERGENT trials. Continued research is necessary to define the safety and place in therapy for older adults. [<i>Journal of Gerontological Nursing, 51</i>(6), 7-12.].</p>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"51 6","pages":"7-12"},"PeriodicalIF":1.1000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of gerontological nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/00989134-20250509-03","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
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Abstract
Purpose: Xanomeline/trospium, a combination of a mixed muscarinic agonist/peripheral antagonist, is a novel treatment for schizophrenia that does not antagonize dopamine receptors. Given its unique pharmacology on the cholinergic system, special considerations may apply for older adults.
Method: The current article reviews the evidence of xanomeline/trospium in older adults as well as implications and considerations for use in practice.
Results: The evidence of using xanomeline/trospium is largely derived from the phase-3 EMERGENT clinical trial program, which investigated safety and efficacy in adults aged 18 to 65 years with schizophrenia. Significant reduction in psychosis was demonstrated; however, gastrointestinal effects were common.
Conclusion: Xanomeline/trospium is a novel treatment for schizophrenia that lacks many of the adverse effects associated with dopamine receptor blockers. Although the package insert provides guidance for use in older adults, patients aged >65 years were excluded from EMERGENT trials. Continued research is necessary to define the safety and place in therapy for older adults. [Journal of Gerontological Nursing, 51(6), 7-12.].
期刊介绍：
The Journal of Gerontological Nursing is a monthly, peer-reviewed journal publishing clinically relevant original articles on the practice of gerontological nursing across the continuum of care in a variety of health care settings, for more than 40 years.
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