What is sublingual dexmedetomidine? Can it be used to treat agitation associated with bipolar disorder?

In this month's edition of our evidence-based clinical psychopharmacology journal club, Dr. Leslie Citrome will interview Dr. Sheldon Preskorn, lead author of a pivotal trial assessing the efficacy of sublingual dexmedetomidine for the treatment of acute agitation associated with bipolar disorder.

This will be a live event at 11:30 AM EST on the 25th of January 2023, hosted by MedscapeLIVE! and QxMD, with opportunity for questions and interaction. Click the 'Full Text Web' button below to register.

Pharmacological strategies to address agitation include a number of intramuscular agents. However, rapidly-acting and effective interventions that do not require an injection may be preferred by both patients and treaters.

Dexmedetomidine is a well-known efficacious alpha-2 adrenergic receptor agonist available since 1999 in an IV formulation indicated for sedation of initially intubated and mechanically ventilated patients in an ICU setting, and sedation of nonintubated patients prior to and/or during surgical and other procedures. The reformulation of dexmedetomidine as a sublingual film allows the broader use of this agent in psychiatric settings when managing agitation in patients with schizophrenia or bipolar disorder, and thus potentially avoiding the use of IM administration of antipsychotics and/or benzodiazepines. Sublingual dexmedetomidine was FDA-approved for this purpose in 2022.

To be discussed is the pivotal trial assessing the efficacy of sublingual dexmedetomidine for the treatment of acute agitation associated with bipolar disorder.