Andrew Miller

Developing a new treatment for any psychiatric condition is already a formidable challenge, but finding one for schizophrenia comes with added complexity. In 2024, a new drug Andrew Miller helped to develop, Cobenfy, was approved to treat schizophrenia, the first new medication using a novel approach for the condition in decades. Existing drugs target the dopamine system of brain chemicals, while Cobenfy focuses on the muscarinic system, which avoids many of the side effects of existing medications that lead 60% or more of patients to stop taking them. Miller tested over 7,000 compounds before discovering that combining one that targeted the muscarinic system with a drug for treating overactive bladders could effectively work on just the muscarinic receptors in the brain to control schizophrenia symptoms and avoid activating them in other parts of the body. Since the bladder treatment had “nothing to do with psychiatry, it was a pretty out-of-the-box approach,” says Miller. But it worked.