Cameron Solnordal says taking medication for schizophrenia, a complex mental illness he lives with, can be stressful.
Solnordal, patron of mental health charity SANE, told SBS News that the sedentary effects of antipsychotic drugs and the weight gain they often cause can disrupt lives and put people off taking them.
Solnordal says that when he first started taking medication for schizophrenia 20 years ago, he gained about 100 pounds in the first few years.
“If you’re still figuring out how the medication is affecting you, and if you’re a new patient, you’re going to gain that weight because not only are you feeling really, really tired and really sedated, but you’re also eating the all the time. as just part of a coping mechanism,” he said.
“It has such a huge numbing effect. When people describe not wanting to use it, it’s because they hate the feeling it gives them – that’s the main reason.”
Recently, a new drug was approved by the US Food and Drug Administration (FDA) for the treatment of schizophrenia. It’s the first time in more than 70 years that an entirely new class of drugs has been approved to treat the condition.
Cobenfy (originally called KarXT) is a combination therapy of two different drugs: xanomeline and trospium.
The drug targets a different set of receptors in the brain than existing antipsychotic medications currently used to treat schizophrenia.
While current medications act on the brain’s dopamine system, Cobenfy targets the cholinergic system, which plays a crucial role in memory, digestion, heart rate, blood pressure and exercise.
Professor Ashley Bush, a researcher at the Florey Institute of Neuroscience and Mental Health in Melbourne, told SBS News he is “very excited” about the FDA’s decision to approve Cobenfy.
“I think it raises hope. The psychiatry community is cautiously optimistic that this could be a really new major asset to add to the schizophrenia toolkit. I think it raises hope for both the patient and the psychiatrist,” said he.
What is schizophrenia?
Schizophrenia is a complex mental health condition that affects approximately 1 percent of people, which equates to approximately 200,000 people in Australia and approximately 24 million people worldwide.
It is characterized by delusions, hallucinations, disorganized speech and behavior, and catatonic behavior (lack of response to the environment or people).
The symptoms of schizophrenia are generally classified into positive symptoms, including hallucinations or delusions, and negative symptoms, including reduced emotional expression and social withdrawal.
What medications are used to treat schizophrenia?
There are currently two types of medications used to treat schizophrenia, including “typical” antipsychotics, which are the first generation of medications for schizophrenia that were developed in the 1950s, and “atypical” antipsychotics, which were developed in the 1990s.
Typical antipsychotics include medications such as chlorpromazine, the first antipsychotic developed from compounds used to treat allergies and in anesthesia.
Atypical antipsychotics include medications such as Clozapine and Risperidone.
However, the side effects of these medications can be wide-ranging and disabling. Antipsychotics have been shown to cause significant weight gain, type 2 diabetes, increased cholesterol, life-threatening constipation, and lower white blood cell counts.
Arthur Christopoulos, dean of the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, told SBS News that existing antipsychotics are ‘dirty drugs’ because they target a large number of receptors and cause many side effects.
“[Cobenfy] is much cleaner,” he said. “It’s a more targeted medicine.”
Where does Cobenfy come from?
Christopoulos said the journey to Cobenfy’s approval began about three decades ago after pharmaceutical researchers discovered molecules that could selectively target receptors known to be important in regulating neurological effects linked to Alzheimer’s disease and schizophrenia .
The drug xanomeline was originally tested in Alzheimer’s patients, but the studies failed due to significant side effects. However, they showed that the drugs significantly reduced symptoms of psychosis.
Later, xanomeline was combined with trospium to alleviate unwanted side effects and this combination became the drug now approved as Cobenfy.
Christopoulos and other researchers from Monash University were involved in a global research effort to develop the drug.
Christopoulos said Cobenfy could be considered an “additional” to current antipsychotic medications and used in combination with them.
“By targeting this receptor system, it is a game changer,” he said.
Although the studies that led to approval in the US lasted only five weeks, the FDA said patients who received Cobenfy “experienced a meaningful reduction in symptoms” compared to the placebo group.
Prescribing information for the drug warns that it can cause urinary retention, increased heart rate, and decreased stomach movement, and is not recommended for patients with hepatic impairment.
Christopoulos said that while it may not be a “miracle cure,” it offers a very different option for medication.
“It will have a significant impact on the lives of people suffering from schizophrenia in Australia and internationally,” he said.
“If I had to choose, I would rather take this drug than the existing antipsychotics.”
Christopoulos said it is too early to say whether the drug will help treat what is known as “treatment-resistant schizophrenia,” in which people continue to experience symptoms despite taking antipsychotic medications.
Treatment-resistant schizophrenia affects about a third of people diagnosed with the condition.
When will it be available in Australia?
Christopoulos said it is unclear when Cobenfy will be approved by Australia’s Therapeutic Goods Administration (TGA), but said “it will happen”.
He said there are fast-track pathways for TGA approval, but it is uncertain whether these will be used.
A spokesperson for the TGA told SBS News it has not yet received an application to register Cobenfy on the Australian Register of Therapeutic Goods.
“The TGA is aware that the US Food and Drug Administration has approved Cobenfy. Should the TGA receive an application, it is important to note that the TGA will independently review all data and make its decision based on the Australian context,” they said. .
Christopoulos also said that without a listing on the Pharmaceutical Benefit Scheme, the drug could be prohibitively expensive for some people.
As for Australians living with schizophrenia, Solnordal said many people could be relieved by the arrival of a new medication option.
“If someone sat down and said, ‘Let’s try to do something better with schizophrenia and the treatment,’ then of course people will raise their heads and say, ‘Finally!'”
“It’s just a matter of making do with what we have, the diagnosis… we’re just making it day by day.”
DEKYAS NEWS World Breaking News and Trusted Source
