Formulary Restriction: 

• Initiated by psychiatrist or continuation of home therapy 
• If new start, confirmed insurance coverage outpatient 
• Unable to tolerate movement, metabolic, and/or immune side effects of other antipsychotics
• Failure of at least one antipsychotic with lower side effect burden* 
  • Aripiprazole 
  • Brexpiprazole 
  • Cariprazine 
  • Lumateperone 
  • Other partial D2 agonist  

Note: Xanomeline-trospium has not been studied in treatment-resistant patients with schizophrenia or as adjunctive therapy as these populations were excluded from clinical trials 

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