Evidence map›Paper›PMID 41540764›Full record

ReviewBrain and behavior2026

Exploring Adjunctive Novel Therapeutic Approach of KarXT (Xanomeline-Trospium Chloride) for Managing Psychotic Symptoms in Patients With Schizophrenia and Alzheimer's Disease.

Ashir Kanwal, Bismah Azeem, Hania Nasir, Fatima Mumtaz, Nauman Ashraf, Mohammed Hammad Jaber Amin, Warisha Kanwal, Bilal Wazir Khan

Abstract readReview
In one paragraph

Review in Brain and behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ashir KanwalDepartment of Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
Bismah AzeemDepartment of Internal Medicine, Avicenna Medical College, Lahore, Pakistan.
Hania NasirDepartment of Internal Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Fatima MumtazDepartment of Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan.
Nauman AshrafDepartment of Psychiatry, Ozark Center, Joplin, USA.
Mohammed Hammad Jaber AminDepartment of Internal Medicine, Alzaiem Alazhari University, Khartoum North, Sudan.
Warisha KanwalDepartment of Internal Medicine, Karachi Medical and Dental College, Karachi, Pakistan.
Bilal Wazir KhanDepartment of Internal Medicine, Khyber Medical College, Peshawar, Khyber Pakhtunkhwa, Pakistan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute psychotic symptoms like delusions and hallucinations are of major concern while treating patients with schizophrenia and alzheimer's psychosis, primarily impacting their daily life functioning and quality of life. The traditional antipsychotic medications, commonly prescribed to manage these symptoms, cause significant side effects with limited efficacy, requiring novel therapeutic agents that can overcome this challenge. While there is no definitive cure, symptomatic treatment can help relieve some of the symptoms and improve the quality of life of people with alzheimer's disease (AD).

methodA comprehensive literature search of PubMed, scopus, google scholar, and ClinicalTrials.gov was conducted to identify studies on xanomeline-trospium chloride (KarXT) in schizophrenia and AD psychosis. After screening 802 unique records, 39 studies-including preclinical, clinical, and observational investigations-were included in this narrative review. Only English-language publications up to February 2025 were considered.

resultKarXT, with its dual action on the M1 and M4 receptors and mAChR antagonism, greatly helps reduce the severity of the positive and negative symptoms, as it resulted in an 8.4-point greater reduction on the PANSS scale. Side effects were minimal and did not account for the discontinuation of treatment.

conclusionPsychosis is a common feature of schizophrenia and AD, most often caused by high concentrations of dopamine in the brain, characterized by hallucinations, delusions, and disorganized thinking, resulting in markedly reduced quality of life for the patient and associated caregiver. Conventional treatments targeting dopamine receptors produce extrapyramidal symptoms and metabolic side effects, leading to noncompliance with medication. KarXT, with its dual action on M1 and M4 receptors and mAChR antagonism, greatly helps reduce the severity of the positive and negative symptoms. The side effects experienced were minimal and did not account for the discontinuation of treatment.An overview of the mechanism of action, clinical trials, and classical findings of KarXT for the management of psychotic symptoms in patients with schizophrenia and alzheimer's disease.

Indexed as

Alzheimer DiseaseAntipsychotic AgentsPsychotic DisordersSchizophreniaHumansQuality of LifeAntipsychotic Agentsalzheimer's psychosisKarXTpsychosis treatmentschizophrenia

Identifiers

PMID41540764
PMCPMC12808924

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.