Recently a new drug was approved for use in the USA to treat schizophrenia in adults. But how does this new drug work? And how effective is it?
What is Schizophrenia?
Worldwide, around 24 million people are currently diagnosed with Schizophrenia. In the UK alone, approximately 1% of the population – around 685,000 people experience symptoms to varying degrees, with 220,000 receiving NHS treatment.
There are a range of symptoms that are associated with Schizophrenia, which you can read about in detail here. But as a brief overview, schizophrenia is a chronic mental health condition, which usually develops in early adulthood, and which affects how a person behaves, thinks and feels. Schizophrenia, a form of psychosis which is characterised by delusions and hallucinations. This can be very frightening and can cause distress for both the people who experience these and their loved ones.
What is the new drug?
The new drug which was recently approved by the FDA in the USA is called Cobenfy (KarXT). It was developed by the pharmaceutical firm Karuna Therapeutics, which was recently acquired by Bristol-Myers Squibb and is taken orally as a capsule. Although the treatment is licenced for use in the USA, it is not yet licenced in the UK.
Prof Matt Jones, Professor of Neuroscience at the University of Bristol, said:
“This new drug promises effective treatment but – crucially – with reduced side effects. Though not approved in the UK yet, it’s obviously great news for people living with schizophrenia, but it’s also great news for psychiatric drug discovery at large. We’ve not hit upon new drugs for decades, and discoveries like this are reinvigorating the field, driving investment and innovation.”
How does it work?
Cobenfy is an ‘antipsychotic’ drug. This means it treats the symptoms that are associated with schizophrenia.
Most existing antipsychotic treatments work by targeting the dopamine receptors in the brain, however Cobenfy is different as it targets the cholinergic receptors instead.
Dopamine is a brain chemical called a neurotransmitter, which means it sends messages around your brain. Scientists believe that symptoms of psychosis are related to these messages and so use antipsychotics to block or reduce dopamine levels.
Cholinergic receptors are proteins on the surface of brain cells that get activated when they bind with a different type of neurotransmitter called acetylcholine. When activated, cholinergic receptors are involved in attention and memory. Further research is needed to understand the mechanism of action that underlies the therapeutic benefits of Cobenfy in psychosis.
Dr Lynsey Bilsland, Head of Mental Health Translation, Wellcome, said:
“Cobenfy is the first new pharmacological approach for treating schizophrenia in over 50 years. It works in a completely different way from any other currently used schizophrenia drugs. It has the potential to change the lives of millions of people. “
Is it more or less effective than existing treatments?
The answer is…we don’t know yet. More research is needed. However, results are promising as initial testing has found a meaningful reduction in psychosis symptoms over a five-week period for patients who took Cobenfy.
Perhaps more importantly, it provides an alternative treatment option for people don’t respond to existing treatments.
Prof David Curtis, Honorary Professor, UCL, said:
“Clinical trials show that this medication does on average improve symptoms in people with schizophrenia. What we would expect is that some people will respond better than others. Since we cannot predict who will respond to which medication, it seems that this would be a treatment well worth trying in anybody who is not doing well on their current medication.”
What research is ongoing?
Other approaches to treating psychosis have been tried. One notable example is a collection of drugs called TAAR1 agonists. These target another, different brain receptor called Trace Amine-Associated Receptors. Recent findings from the GALENOS project, supported by MQ, found that whilst these TAAR1 agonists had fewer side effects than existing antipsychotics they were generally not as effective.
Another notable study is the PUMA trial. PUMA is a Wellcome-funded project that aims to design and set up a clinical trial for early psychosis using an innovative multi-arm, multi-stage adaptive design. This clinical trial will be co-designed with patients with early psychosis and carers of individuals with early psychosis to test promising new treatments for early psychosis.
Without research, it’s just guesswork.
Developments in treatments for serious mental illnesses such as schizophrenia are only made possible through research. MQ supports vital scientific research so that we can develop new treatments like these, new interventions such as talking therapies and improve the way people can access care.
You can be part of the next breakthrough in mental health research. Become an MQ supporter today.
