Cobenfy (xanomeline-trospium) is the first schizophrenia drug in 50 years that doesn't block D2. That changes the side-effect conversation, the titration plan, and where the medication sits in your treatment algorithm. This Deep Dive walks through what 2026 PMHNPs need to know to actually prescribe it: the muscarinic M1/M4 mechanism in plain English, the titration schedule and what to do if the GI side effects show up early, the patients you'd preferentially trial it in (and the ones you wouldn't), and how the cost / prior-auth picture compares to a quetiapine or aripiprazole trial. You will come away with: - A concrete starting dose and titration plan - The cholinergic side-effect playbook (and why this isn't just "another atypical") - A practical answer to "where does this fit before vs. after a long-acting injectable?" Full prescribing guide w ...