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Let’s Stop Ignoring the Neurotransmitter Acetylcholine

9 min readMay 7, 2025

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Four bright red mushrooms with white spots.
Amanita muscaria (fly agaric). Image: Ella / Pixabay

Why would a drug company release a new medication that contains two agents — one that activates a neurotransmitter receptor, and the other that blocks action at the very same receptor? Don’t they just cancel out and become an expensive placebo?

Cobenfy, the newest antipsychotic on the market, and one that some experts consider a game changer in the field, consists of the acetylcholine activator xenomaline, and the acetylcholine blocker trospium. It’s considered innovative because it’s the first medication for schizophrenia in 50 years that doesn’t just shut down dopamine receptors.

The implications for Cobenfy extend far beyond schizophrenia. Unlike all previous antipsychotics, Cobenfy also seems to remediate not just psychotic symptoms like hallucinations and delusions, but some of the cognitive problems of schizophrenia as well. Neuroscientists are studying whether Cobenfy or similar agents might help with dementia, depression, ADHD and other conditions that can affect thinking and decision making.

Although it gets far less press than flashier neurotransmitters like dopamine and serotonin…

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Wise & Well

Published in Wise & Well

Science-backed insights into health, wellness and wisdom, to help you make tomorrow a little better than today.

John Kruse MD, PhD
John Kruse MD, PhD

Written by John Kruse MD, PhD

Psychiatrist, neuroscientist, gay father of twins, marathon runner, in Hawaii. 200+ ADHD & mental health videos https://www.youtube.com/@DrJohnKruse