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Abstract

Schizophrenia represents one of the most challenging psychiatric disorders, which affects about 1% of the global population and ranks between the main causes of disability worldwide. This extensive review examines the modern therapeutic landscape of schizophrenia, including recent advances from 2020 to 2025. The article synthesizes the current evidence on medicinal intervention, psychological treatment and emerging medical form. In particular, the recent FDA approval of the KarXT (Cobenfy) in September 2024 marks the first novel mechanism of action in schizophrenia treatment in more than 70 years, which represents a paradigm change from traditional dopamine-targeted remedies. This review analyses the efficacy, safety profile and clinical implications of current treatments, discovering future instructions in accurate medical, digital medical and circuit-based interventions. Integration of individual treatment approaches, enhanced psychosocial intervention, and novels provide unprecedented opportunities to improve results in individuals with medicinal target schizophrenia.

Keywords

Schizophrenia, Therapeutic landscape, KarXT (Cobenfy), Dopamine-targeted remedies, Precision medicine

Introduction

Schizophrenia is one of the most challenging psychiatric disorders, which puts a significant burden on global mental health systems due to its versatile symptoms. Symptoms of the condition are characterized by a triad of the domain: positive symptoms (such as hallucinations and confusion), negative symptoms (including Avolition, Anhedonia and social withdrawal), and cognitive loss that collectively contribute to intensive functional disability. Despite decades of research and therapeutic progression, the adequate proportion of patients performs treatment-resistant schizophrenia (TRS), about 10–30% shows minimal response to traditional antipsychotics and additional 50–60% only gets partial symptoms relief. This outlines the boundaries of existing dopamine-centric pharmacotherapy and highlights the immediate need for novel therapeutic strategies. The therapeutic landscape of schizophrenia has made transformational changes between 2020 and 2025, which are inspired by successes in neurobiology, genomics and digital health innovations. This period was a decisive milestone FDA approval of KarXT (Xanomeline-trospium) in 2024, which marked the first antipsychotic with a novel muscarinic receptor-based mechanism in seven decades-a paradigm change from conventional D2 receptor.  In addition, emerging methods such as pricy medicine, circuit-based neuromodulator and AI-powered digital therapeutics are re-shaping the intervention approach. This review synthesizes contemporary evidence on medicinal, psychological and technological progress in schizophrenia management, offering evidence-based treatment to physicians and researchers to doctors and researchers offer a comprehensive update on future directions.

Reference

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Deep Jyoti Shah
Corresponding author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Mahesh Kumar Yadav
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Pintu Kumar
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Love Mahato
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Kush Mahato
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Dulari Majhi
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Aditya Raj Gupta
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Shaima Siddique
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Rishu Raj
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Ashish Kumar
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Rup Kumar
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Shashi Ranjan
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Varsha Raj
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Tahmina Khatoon
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Saurabh Chaudhary
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Kamlesh Kumar
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Mayank Kumar
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Navnit Kumar Thakur
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Kristy Kumari
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

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Abhinav Kumar
Co-author

Faculty of Medical Science and Research, Sai Nath University, Ranchi, Jharkhand-835219, India

Deep Jyoti Shah*, Mahesh Kumar Yadav, Pintu Kumar, Love Mahato, Kush Mahato, Dulari Majhi, Aditya Raj Gupta, Shaima Siddique, Rishu Raj, Ashish Kumar, Rup Kumar, Shashi Ranjan, Varsha Raj, Tahmina Khatoon, Saurabh Chaudhary, Kamlesh Kumar, Mayank Kumar, Navnit Kumar Thakur, Kristy Kumari, Abhinav Kumar, Modern Therapeutic Approach towards Schizophrenia: A Comprehensive Review of Contemporary Treatment Strategies and Emerging Innovations, Int. J. Sci. R. Tech., 2025, 2 (9), 254-265. https://doi.org/10.5281/zenodo.17197202

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