Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review

Acute agitation occurs in a variety of medical and psychiatric conditions and is the clinical presentation in a significant percentage of urgent psychiatric episodes, requiring prompt and effective intervention. Traditionally, agitation was managed in psychiatric wards using physical restraint. Wit...

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Main Authors: Sabrina Magueta, Ana Costa, Gisela Simões, João Alcafache, Paula Garrido
Format: Article
Language:English
Published: Sociedade Portuguesa de Psiquiatria e Saúde Mental 2024-04-01
Series:Revista Portuguesa de Psiquiatria e Saúde Mental
Subjects:
Online Access:https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/506
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author Sabrina Magueta
Ana Costa
Gisela Simões
João Alcafache
Paula Garrido
author_facet Sabrina Magueta
Ana Costa
Gisela Simões
João Alcafache
Paula Garrido
author_sort Sabrina Magueta
collection DOAJ
description Acute agitation occurs in a variety of medical and psychiatric conditions and is the clinical presentation in a significant percentage of urgent psychiatric episodes, requiring prompt and effective intervention. Traditionally, agitation was managed in psychiatric wards using physical restraint. With the advent of tranquilizing neuroleptics, such as chlorpromazine, the pharmacological management of these conditions became possible. Acute agitation, although a potential result of most psychiatric disorders, is often associated with psychotic conditions, mood disorders and neurodegenerative disorders. The authors propose to explore dexmedetomidine as a therapeutic option in states of acute agitation in psychiatric patients in which traditional drugs are not effective. The authors based the work on a non-systematic review of the literature. Keywords used included: dexmedetomidine, acute agitation, rapid tranquilisation, restraint, sedation, psychiatric population and psychiatric disorders. Recently, a significant step forward in methods of treating acute agitation has been achieved through the use of dexmedetomidine in psychiatric patients. It is a selective α2‐receptor agonist being approved for short‐term sedation with the benefit of not having excessive sedation, thus allowing a concomitant psychotherapeutic approach. This proves to be a promising treatment option for those with acute agitation. The amount of studies available on its usefulness in psychiatric mental illness are still scarce. The interventional recommendations in the literature for agitation were developed based on research data, theoretical considerations and clinical experience, however, studies that provide definitive data are needed. It is imperative that the investigation of episodes of acute agitation and their restraint evolve, in order to protect these patients from the consequences of this behaviour and its treatment. Exploring the potential of dexmedetomidine as a tool in the mental health professional’s kit is well deserved as there are few alternatives that reassure the highly agitated patient without excessive sedation.
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spelling doaj.art-1dfe78b823e84d0ab1d23055d7e7fe7f2024-04-09T22:40:43ZengSociedade Portuguesa de Psiquiatria e Saúde MentalRevista Portuguesa de Psiquiatria e Saúde Mental2184-55222184-54172024-04-0110110.51338/rppsm.506Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative ReviewSabrina Magueta0Ana Costa1Gisela Simões2João Alcafache3Paula Garrido4Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar do Baixo Vouga, Aveiro, PortugalDepartamento de Psiquiatria e Saúde Mental, Centro Hospitalar do Baixo Vouga, Aveiro, PortugalDepartamento de Psiquiatria e Saúde Mental, Centro Hospitalar do Baixo Vouga, Aveiro, PortugalDepartamento de Psiquiatria e Saúde Mental, Centro Hospitalar do Baixo Vouga, Aveiro, PortugalDepartamento de Psiquiatria e Saúde Mental, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal Acute agitation occurs in a variety of medical and psychiatric conditions and is the clinical presentation in a significant percentage of urgent psychiatric episodes, requiring prompt and effective intervention. Traditionally, agitation was managed in psychiatric wards using physical restraint. With the advent of tranquilizing neuroleptics, such as chlorpromazine, the pharmacological management of these conditions became possible. Acute agitation, although a potential result of most psychiatric disorders, is often associated with psychotic conditions, mood disorders and neurodegenerative disorders. The authors propose to explore dexmedetomidine as a therapeutic option in states of acute agitation in psychiatric patients in which traditional drugs are not effective. The authors based the work on a non-systematic review of the literature. Keywords used included: dexmedetomidine, acute agitation, rapid tranquilisation, restraint, sedation, psychiatric population and psychiatric disorders. Recently, a significant step forward in methods of treating acute agitation has been achieved through the use of dexmedetomidine in psychiatric patients. It is a selective α2‐receptor agonist being approved for short‐term sedation with the benefit of not having excessive sedation, thus allowing a concomitant psychotherapeutic approach. This proves to be a promising treatment option for those with acute agitation. The amount of studies available on its usefulness in psychiatric mental illness are still scarce. The interventional recommendations in the literature for agitation were developed based on research data, theoretical considerations and clinical experience, however, studies that provide definitive data are needed. It is imperative that the investigation of episodes of acute agitation and their restraint evolve, in order to protect these patients from the consequences of this behaviour and its treatment. Exploring the potential of dexmedetomidine as a tool in the mental health professional’s kit is well deserved as there are few alternatives that reassure the highly agitated patient without excessive sedation. https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/506Dexmedetomidine/therapeutic usePsychomotor Agitation/drug therapy
spellingShingle Sabrina Magueta
Ana Costa
Gisela Simões
João Alcafache
Paula Garrido
Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review
Revista Portuguesa de Psiquiatria e Saúde Mental
Dexmedetomidine/therapeutic use
Psychomotor Agitation/drug therapy
title Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review
title_full Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review
title_fullStr Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review
title_full_unstemmed Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review
title_short Dexmedetomidine as an Emerging Treatment of Agitation in Psychiatric Patients: A Narrative Review
title_sort dexmedetomidine as an emerging treatment of agitation in psychiatric patients a narrative review
topic Dexmedetomidine/therapeutic use
Psychomotor Agitation/drug therapy
url https://www.revistapsiquiatria.pt/index.php/sppsm/article/view/506
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AT giselasimoes dexmedetomidineasanemergingtreatmentofagitationinpsychiatricpatientsanarrativereview
AT joaoalcafache dexmedetomidineasanemergingtreatmentofagitationinpsychiatricpatientsanarrativereview
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