FDA approval of Cobenfy illuminates schizophrenia’s evil.

• The U.S. Food and Drug Administration (FDA) has approved Cobenfy, a drug combining xanomeline and trospium chloride.

• Cobenfy, a combination of these drugs, has a novel mechanism of action that avoids the side effects of older drugs.

• Schizophrenia is a serious psychiatric disorder with life-changing consequences, including social isolation, stigma, and diminished chances of finding a partner.

• The disease affects one in a hundred people in their lifetime, with a slightly higher prevalence in men.

• The clinical phenotype of schizophrenia includes reality distortion, disorganisation, and negative symptoms.

• Positive symptoms include delusions, hallucinations, and a pattern of speech difficult to follow.

• Negative symptoms include reduction in the quantity of words spoken, reduced goal-directed activities, apathy or lack of motivation, anergia, reduced experience of pleasure, and reduced expression of emotions.

• Disorganisation symptoms include formal thought disorder, disorganised behaviour, and inappropriate affect.

• Cognitive impairment is ubiquitous in schizophrenia, with patients showing impaired performance on various cognitive tests.

• Schizophrenia is a multifactorial disorder, with genetic variants playing a direct role in the brain by changing gene expression.

• The drug Cobenfy targets cholinergic receptors, unlike dopamine receptors, which have been implicated in the genesis of schizophrenia.

• The FDA stated that Cobenfy’s most common side-effects include nausea, indigestion, hypertension, tachycardia, and dizziness.