NEI Podcast E243 - A Look Back at This Year in Psychopharmacology with Dr. Roger McIntyre
Dec 4, 2024
Dr. Roger McIntyre, a leading mental health expert in psychopharmacology, joins Dr. Andy Cutler to reflect on significant advances in the field this year. They dive into groundbreaking treatments for schizophrenia, discussing innovative drugs and their potential in improving cognitive and negative symptoms. The conversation also covers the complexities of prescribing anticholinergic medications and advancements in TMS therapy for adolescent depression. Insights on suicidality, mood disorders, and the interplay between sleep and mental health leave listeners with a deeper understanding of these crucial topics.
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Kobenfi Approval: A Paradigm Shift
- On September 26th, 2024, the FDA approved a new drug for schizophrenia with a novel mechanism.
- This marks a paradigm shift in psychopharmacology, comparable to the approval of the first NMDA antagonist for TRD.
Kobenfi's Novel Mechanism
- Kobenfi (xenomeline and trospium) is a muscarinic agonist, unlike previous antipsychotics that primarily block dopamine receptors.
- This new mechanism avoids side effects like weight gain, metabolic issues, and movement disorders commonly associated with D2 blockers.
Kobenfi and Anticholinergics
- Avoid combining Kobenfi with anticholinergics due to potential systemic toxicity.
- Gradually taper patients off anticholinergics before starting Kobenfi, especially those with intrinsic anticholinergic activity.