Original Research J Clin Psychiatry May 2022

Antipsychotic Efficacy of KarXT (Xanomeline−Trospium): Post Hoc Analysis of Positive and Negative Syndrome Scale Categorical Response Rates, Time Course of Response, and Symptom Domains of Response in a Phase 2 Study

JCP 2022;83(3):10.4088/JCP.21m14316

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Acute schizophrenia still relies on dopamine D2-blocking antipsychotics, which leave many clinicians balancing symptom control against extrapyramidal effects, prolactin elevation, and tardive dyskinesia risk. This analysis asks a practical question for inpatient care: how often KarXT produces clinically meaningful PANSS response, how quickly that response emerges, and whether benefit extends beyond positive symptoms. FAQ What did this phase 2 study find about KarXT for acute psychosis in schizophrenia?

Key Takeaways At week 5, 59.0% (n = 49) of KarXT-treated patients achieved a ≥ 20% PANSS total score reduction, while 15.7% (n = 13) achieved a ≥ 50% reduction, showing that response rates fell as a more stringent threshold was applied. Clinical Guide How should clinicians judge whether KarXT is producing a meaningful early response in acutely psychotic inpatients with schizophrenia? Clinical Guide How can clinicians assess whether KarXT is improving symptom domains beyond positive symptoms in acute schizophrenia?