Advancements in Antipsychotic Medications and Potential of Modulating M4 Muscarinic Receptors

Current research is focusing on a new mechanism to control schizophrenic symptoms by modulating M4 muscarinic receptors. The drug xenolamine, an M4 agonist, is likely to be the first available in this area. This approach aims to modulate the release of dopamine in a specific circuit pre-synaptically, rather than blocking dopamine post-synaptically. Allosteric receptors and trace-amine associated receptor molecules are also being studied to modulate the same circuit. Developing a long-acting injectable version of clozapine may be challenging due to the high doses required, but there are ongoing efforts to explore options like subcutaneous gels containing an adequate amount of clozapine, currently available in some countries for initiation of treatment.