Explanation of how muscarinic antipsychotics work

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In the minute 13:13. There is also the structure of KarXT, which I had never seen before.

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Is it true that they lower dopamine?

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Yeah. Unlike conventional ones, which directly block d2/d3 receptors. Muscarinics decrease dopamine in some areas of the brain indirectly. But they don’t block it.

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Yea I saw in the video it only reduces dopamine in positive symptoms brain regions, current meds block dopamine in all the brain. Should be better for negative and cognitive symptoms.

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Exactly! Our quality of life will improve significantly. My concern is the time and how long it will take to distribute it. I suppose that after it is approved in the United States it will go to Europe and then finally to South America.

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Its basically a selective cholinergic agonist , with a selctive cholinergic antagonist combined to reduce side effects of the agonist as a standalone.

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The antagonist is only peripheral, outside the brain. Its to reduce peripheral side effects like constipation, dry mouth, nausea etc

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if it is really so much better i will emigrate to us! :smiley:

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Theoretically they are very demanding with the visa. If it were easy, I would have also left for the United States a long time ago :joy: :joy:

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The nausea with KarXT will be unbearable, I think some third generation antipsychotics would be better but its worth a try.

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In the video they say this medication is from betel nuts eaten in south asia, they have less sz risk from it. Interesting

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My impression is that Emraclidine will be better than KarXT. It does not need a combination with another drug and only binds to M4 receptors.

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But isn’t m1 agonist better for cognition?

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I prefer nausea over suicidal thoughts or indefinite weight gain or problems socializing. It will depend a lot on each person. Some will continue on conventional antipsychotics, it seems to me. Time will tell.

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I honestly don’t know :joy:

I wonder if there is a doctor participating in this forum to clarify the doubt.
Today I went to my psychiatrist and asked him about KarXT. He told me that it will be better for the negative symptoms but it will not be the ‘‘perfect pill’’

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