{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T21:11:09Z","timestamp":1761340269073,"version":"build-2065373602"},"reference-count":6,"publisher":"American Association of Psychiatric Pharmacists (AAPP)","issue":"5","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>Xanomeline\/trospium is a newly approved agent for the management of schizophrenia. Unlike traditional antipsychotics, which are D<jats:sub>2<\/jats:sub> receptor antagonists, xanomeline is an M<jats:sub>1<\/jats:sub>\/M<jats:sub>4<\/jats:sub> muscarinic acetylcholine receptor agonist coformulated with trospium, a peripheral muscarinic antagonist. The addition of the trospium constituent aims to reduce or prevent the peripheral effects of muscarinic acetylcholine receptor agonism by xanomeline, which would include classic cholinergic adverse effects such as increased salivation, defecation, and urination. The package insert reports that some of the most frequently observed adverse reactions (incidence \u22655%) throughout clinical trials were those congruent with the expected anticholinergic effects of trospium, such as urinary retention and constipation, as well as other reactions that likely coincide with xanomeline use, such as nausea, vomiting, and diarrhea.<jats:sup>1<\/jats:sup> However, there is no documented incidence of polyuria secondary to xanomeline\/trospium use in the current literature. We present a case of a 53-year-old White male who was treated with xanomeline\/trospium for the management of schizophrenia who experienced polyuria after a dose titration to maximum dosing of xanomeline\/trospium 125 mg\/30 mg by mouth twice daily. Owing to the emergence of polyuria 3 days after the dose titration, the xanomeline\/trospium was discontinued after discussion with the provider, and the polyuria resolved within 1 day.<\/jats:p>","DOI":"10.9740\/mhc.2025.10.255","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:33:18Z","timestamp":1759321998000},"page":"255-257","source":"Crossref","is-referenced-by-count":1,"title":["Xanomeline\/trospium-induced polyuria: A patient case report"],"prefix":"10.9740","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1142-9868","authenticated-orcid":true,"given":"Henry","family":"Leach","sequence":"first","affiliation":[{"name":"Clinical Coordinator, PGY-2 Psychiatric Pharmacy Residency Program Director, Toms River New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9175-4881","authenticated-orcid":true,"given":"Francesca","family":"DiGuglielmo","sequence":"additional","affiliation":[{"name":"(Corresponding author) PGY-2 Psychiatric Pharmacy Resident, Toms River, New Jersey, francesca.diguglielmo@rwjbh.org"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4719","reference":[{"key":"i2168-9709-15-5-255-b01","series-title":"DailyMed. National Library of Medicine","article-title":"COBENFY  LLC (xanomeline and trospium chloride) prescribing information","author":"Squibb & Sons","unstructured":"Squibb & Sons ER. COBENFY  LLC (xanomeline and trospium chloride) prescribing information. Revised September 2024. DailyMed. National Library of Medicine. Accessed March 2025. https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=8f0e73bf-6025-44f6-ab64-0983322de0df."},{"issue":"26","key":"i2168-9709-15-5-255-b02","series-title":"Proc Natl Acad Sci USA","first-page":"8124","article-title":"Muscarinic regulation of dopamine and glutamate transmission in the nucleus accumbens","volume":"112","author":"Shin","year":"2015","unstructured":"Shin JH,\nAdrover MF,\nWess J,\nAlvarez VA. Muscarinic regulation of dopamine and glutamate transmission in the nucleus accumbens. Proc Natl Acad Sci USA. 2015;112(26):8124-9. Corrected and republished from: Proc Natl Acad Sci U S A. 2015;112(36):E5111.  DOI: 10.1073\/pnas.1508846112"},{"issue":"5","key":"i2168-9709-15-5-255-b03","series-title":"Pharmacology","first-page":"301","article-title":"Mechanisms of M3 muscarinic receptor regulation by wash-resistant xanomeline binding","volume":"83","author":"Noetzel","year":"2009","unstructured":"Noetzel MJ,\nGrant MK,\nEl-Fakahany EE. Mechanisms of M3 muscarinic receptor regulation by wash-resistant xanomeline binding. Pharmacology. 2009;83(5):301-17. DOI: 10.1159\/000214843"},{"issue":"7","key":"i2168-9709-15-5-255-b04","series-title":"Br J Pharmacol","first-page":"1413","article-title":"Functional effects of the muscarinic receptor agonist, xanomeline, at 5-HT1 and 5-HT2 receptors","volume":"125","author":"Watson","year":"1998","unstructured":"Watson J,\nBrough S,\nColdwell MC,\nGager T,\nHo M,\nHunter AJ, et al. Functional effects of the muscarinic receptor agonist, xanomeline, at 5-HT1 and 5-HT2 receptors. Br J Pharmacol. 1998;125(7):1413-20. DOI: 10.1038\/sj.bjp.0702201"},{"issue":"8","key":"i2168-9709-15-5-255-b05","series-title":"N Engl J Med","first-page":"786","article-title":"Management of overactive bladder","volume":"350","author":"Ouslander","year":"2004","unstructured":"Ouslander JG. Management of overactive bladder. N Engl J Med. 2004;350(8):786-99. DOI: 10.1056\/NEJMra032662"},{"article-title":"Adverse drug reaction probability scale (Naranjo) in drug induced liver injury. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury","year":"2012","key":"i2168-9709-15-5-255-b06","unstructured":"Adverse drug reaction probability scale (Naranjo) in drug induced liver injury. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]; 2012. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548069\/."}],"container-title":["Mental Health Clinician"],"original-title":[],"link":[{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/15\/5\/article-p255.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/mhc.kglmeridian.com\/downloadpdf\/journals\/mhcl\/15\/5\/article-p255.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/mhc.kglmeridian.com\/downloadpdf\/journals\/mhcl\/15\/5\/article-p255.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:32:21Z","timestamp":1759365141000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhc.kglmeridian.com\/view\/journals\/mhcl\/15\/5\/article-p255.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":6,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.9740\/mhc.2025.10.255","relation":{},"ISSN":["2168-9709"],"issn-type":[{"type":"electronic","value":"2168-9709"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}