English Clayton, Bergeron Kaela, Mike Leigh Ann
J Gerontol Nurs. 2025 Jun;51(6):7-12. doi: 10.3928/00989134-20250509-03. Epub 2025 Jun 1.
Xanomeline/trospium, a combination of a mixed muscarinic agonist/peripheral antagonist, is a novel treatment for schizophrenia that does not antagonize dopamine receptors. Given its unique pharmacology on the cholinergic system, special considerations may apply for older adults.
The current article reviews the evidence of xanomeline/trospium in older adults as well as implications and considerations for use in practice.
The evidence of using xanomeline/trospium is largely derived from the phase-3 EMERGENT clinical trial program, which investigated safety and efficacy in adults aged 18 to 65 years with schizophrenia. Significant reduction in psychosis was demonstrated; however, gastrointestinal effects were common.
Xanomeline/trospium is a novel treatment for schizophrenia that lacks many of the adverse effects associated with dopamine receptor blockers. Although the package insert provides guidance for use in older adults, patients aged >65 years were excluded from EMERGENT trials. Continued research is necessary to define the safety and place in therapy for older adults. [(6), 7-12.].
占诺美林/曲司氯铵是一种毒蕈碱混合激动剂/外周拮抗剂的组合，是一种新型的不拮抗多巴胺受体的精神分裂症治疗药物。鉴于其对胆碱能系统独特的药理学作用，老年患者可能需要特殊考虑。
本文综述了占诺美林/曲司氯铵在老年患者中的证据以及在实际应用中的意义和注意事项。
使用占诺美林/曲司氯铵的证据主要来自3期EMERGENT临床试验项目，该项目研究了18至65岁精神分裂症成年患者的安全性和有效性。结果显示精神病症状显著减轻；然而，胃肠道不良反应较为常见。
占诺美林/曲司氯铵是一种新型的精神分裂症治疗药物，缺乏许多与多巴胺受体阻滞剂相关的不良反应。虽然药品说明书为老年患者的使用提供了指导，但65岁以上的患者被排除在EMERGENT试验之外。有必要继续开展研究以明确其在老年患者中的安全性和治疗地位。[(6), 7 - 12.]
