schizophrenia is a heavy disease. Although there are many feasible drugs to choose from, the treatment is still full of challenges.Fortunately, some new drugs are under development, and the limitations aim to overcome existing treatment methods.
Limitation of the dopamine antagonist
For more than 50 years, anti -ejaculating drugs that block dopamine signal transmission have always been the treatment of schizophreniaStandard drugs.Its prevalence is based on classic dopamine hypotheses. The hypothesis believes that D2 receptor is related to mental symptoms.
Unfortunately, blocking D2 receptors can also cause some side effects related to movement, such as delayed motor disorder and slow exercise.The second -generation anti -psychiatric drugs are more likely to tolerate in some ways, but they also have metabolic side effects, which may exacerbate existing problems.
New direction of schizophrenia
Study on schizophrenia has surpassed the initial attention to dopamine.It now includes new understanding of choline system, glutamic acid and NMDA receptor, and recently discovered trace amine -related receptors (TAARS).Several drugs of non -dopamine can be used in different development stages.
1) The US Food and Drug Administration approved Kar-XT (xanomeline-Trospium) in September this year.This is the first new treatment method for schizophrenia approved by FDA for decades.
xanomeline is a oral poisonous pyrine agonist, twice a day, targeting M1 and M4 receptors.Because it is used in combination with peripheral poisoning antagonine antagonists, it will not produce typical side effects of choline energy.The Emergent clinical trial evaluated Kar-XT shows a positive overall effect. Compared with placebo, its positive and negative symptom scores have improved significantly, and continuously improved in the 52-week open label trial.KAR-XT also has good metabolic characteristics, and there are few adverse reactions.During the one-year treatment, KAR-XT did not have serious side effects, especially the weight gain and metabolic dysfunction, and there were no symptoms of external tutoring, which highlighted it.The potential for choice.
2) Terxt is also accelerating.This is a kind of XANOMELINE and Trospium pre -clinical drugs in the clinical development stage.The daily oral and long -term injection preparations will bring advantages in terms of dosage and compliance.
3) NBI-1117568 is a compound that is being developed. As a selective orthogonal agent, it also takes M4 receptor as its target.This oral drug once a day. According to reports, the preliminary test only obtained a positive second phase of data at the lowest dose of the four test doses, and plans to conduct third -stage tests in 2025.
4) Another oral drug Emraclidine, an oral drug with a targeting poisonous pyrodoline M4 receptor, is conducting a two -stage test.It shows the prospects of positive and negative symptoms in the first stage test.Compared with Kar-XT, its dosage and minimum gastrointestinal effect may be an advantage every day.
5) ULOTARONT is conducting a 3 -stage test, which is the first schizophrenia drug with TAAR1 as the target.Although the results of the 2 -stage test were good and the title of breakthrough therapy was awarded by the FDA, the preliminary results of the third phase test showed that the symptom scores did not significantly improve compared with the placebo.Sumitomo Pharmaceutical Company explained that this may be due to the "placement reaction", "this is well -founded in the clinical study of mental illness."Sumitomo Pharmaceutical and Okasaki Pharmaceutical Plan continued to cooperate with the US Food and Drug Administration to carry out the next step.
Auxiliary therapy in research
There are other non -dopamine mechanisms, which are used to treat residual symptoms of schizophreniaHe also accepted the assessment, and the result was halfway.
Researchers have studied a 5-HT2A reverse agonist and antagonist PIMAVANSERIN approved for Parkinsons mental illness to treat them as the treatment drugs with negative symptoms of schizophrenia.EssenceHowever, it has not reached the main end in the third phase test.
Glycine Transfer-iclepertin as auxiliary drugs for schizophrenia cognitive disorder.The cognitive ability is shown in the dose with good tolerance.
As a potential treatment for cognitive disorders of schizophrenia, another compound that has attracted much attention is Alto-101, as a PDE4 inhibitor, with a unique mechanismAnd can be administered through skin.The second -stage test has just begun, and preliminary results are expected to obtain next year.
The research direction of schizophrenia has undergone an exciting change, because it is now exploring new targets other than dopamine receptors.Researchers, prescription doctors, patients, and nursing workers hope to bring more effective and tolerance treatment solutions.
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