Treatment-resistant Parkinson's disease psychosis responding to xanomeline-trospium: A case report. (PubMed, Clin Park Relat Disord) - Sep 13, 2026 - "He was referred specifically for a trial of clozapine therapy, which the patient and caregiver declined due to its risk profile. The patient's psychosis proved refractory to three pharmacologically distinct therapies-quetiapine, a low-affinity, rapidly dissociating dopamine D2 receptor antagonist; brexpiprazole, a dopamine D2 partial agonist; and pimavanserin, a selective 5-HT2A receptor inverse agonist-before improving with xanomeline-trospium, whose antipsychotic effects are mediated through central M1/M4 muscarinic receptor agonism. This case supports the further investigation of muscarinic receptor agonism as a therapeutic strategy for Parkinson's disease psychosis."
Journal • CNS Disorders • Movement Disorders • Parkinson's Disease • Psychiatry • DRD2
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Andrew Farah; Heather Garrison; Karen Timbrook-Dillow
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