Effect of Sublingual Dexmedetomidine vs Placebo on Acute Agitation Associated With Bipolar Disorder: A Randomized Clinical Trial
RCT (n=380) found sublingual dexmedetomidine at dose of 180mcg or 120mcg reduced mild-moderate agitation vs. placebo at 2 hours after treatment (Positive & Negative Syndrome Scale-Excited Component total score of−10.4, −9.0 & −4.9, respectively; possible total score range, 5-35).
Source:
Journal of the American Medical Association
SPS commentary:
According to an editorial, the study introduces and provides evidence to support a novel, potentially important addition to the armamentarium for managing behavioural agitation. It notes that even if this form of sublingual dexmedetomidine is never marketed (or its cost is prohibitive), the results from this trial call attention to novel-use cases for dexmedetomidine outside the critical care setting and beyond sedation for procedures. It adds that more research in diverse settings with different formulations of dexmedetomidine is needed to define how this unique noradrenergic sedative might best be used in clinical management of agitated patients.