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Description

Purpose This literature review aims to evaluate the clinical use of dexmedetomidine in psychiatry, specifically in the management of neurobehavioral manifestations associated with psychiatric diagnoses defined by the DSM-5 or ICD-10. Dexmedetomidine, an alpha-2 receptor agonist, effectively reduces a heightened sympathetic response and provides sedative, analgesic, and anti-inflammatory effects. The neurobehavioral manifestations include psychomotor agitation, delirium, catatonia, impaired focus, hyperactivity, mania, and hallucinations as seen in psychiatric conditions such as bipolar disorder, schizophrenia, alcohol withdrawal syndrome, ADHD, and autism. The purpose of this review is to identify use of dexmedetomidine in clinical psychiatry in controlling neurobehavioral manifestations and identifying its effectiveness and safety profile. lit

Methods This literature review includes studies where dexmedetomidine was administered to patients with psychiatric diagnoses for managing neurobehavioral manifestations in both an inpatient and outpatient setting. Psychiatric diagnoses met the diagnostic criteria in the DSM-5 or ICD-10. Literature was sourced from databases including PubMed, PsycINFO, and Embase, focusing on human and animal studies. The review includes randomized controlled trials, observational studies, and literature reviews. Data about dexmedetomidine's indications, mechanisms of action, routes of administration, treatment outcomes, and adverse effects were included.

Results The review found that dexmedetomidine effectively reduces psychomotor agitation in patients with bipolar disorder, schizophrenia, and withdrawal syndromes, without severe sedation or respiratory depression. In alcohol withdrawal syndrome, dexmedetomidine safely managed autonomic hyperactivity and prevented progression to delirium tremens. Animal studies highlighted its potential to mitigate ADHD-like symptoms by reducing gut-brain axis inflammation, improving focus, and decreasing hyperactivity. Its anti-inflammatory and neuroprotective effects also showed promise in improving memory and reducing neuroinflammation in conditions like Alzheimer’s disease and depression. Additionally, in autism patients presenting with catatonia, dexmedetomidine provided acute stabilization.

Conclusions Dexmedetomidine demonstrates potential to reduce neurobehavioral manifestations in psychiatry while also providing a safer side effect profile. Dexmedetomidine was successful in managing psychomotor agitation, delirium in alcohol withdrawal syndrome, ADHD, and catatonia in autism. Additionally, dexmedetomidine's neuroprotective effects may have potential in improving neuroinflammatory disorders like Alzheimer’s disease and depression. Dexmedetomidine’s ability to effectively reduce sympathetic hyperactivity without significant side effect risk emphasizes its potential in psychiatric care.

Disciplines

Psychiatry

Keywords

Dexmedetomidine, neurobehavioral manifestations, catatonia, delirium, psychomotor agitation

Document Type

Poster

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Psychiatry Commons

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Role of dexmedetomidine in psychiatry - a literature review

Purpose This literature review aims to evaluate the clinical use of dexmedetomidine in psychiatry, specifically in the management of neurobehavioral manifestations associated with psychiatric diagnoses defined by the DSM-5 or ICD-10. Dexmedetomidine, an alpha-2 receptor agonist, effectively reduces a heightened sympathetic response and provides sedative, analgesic, and anti-inflammatory effects. The neurobehavioral manifestations include psychomotor agitation, delirium, catatonia, impaired focus, hyperactivity, mania, and hallucinations as seen in psychiatric conditions such as bipolar disorder, schizophrenia, alcohol withdrawal syndrome, ADHD, and autism. The purpose of this review is to identify use of dexmedetomidine in clinical psychiatry in controlling neurobehavioral manifestations and identifying its effectiveness and safety profile. lit

Methods This literature review includes studies where dexmedetomidine was administered to patients with psychiatric diagnoses for managing neurobehavioral manifestations in both an inpatient and outpatient setting. Psychiatric diagnoses met the diagnostic criteria in the DSM-5 or ICD-10. Literature was sourced from databases including PubMed, PsycINFO, and Embase, focusing on human and animal studies. The review includes randomized controlled trials, observational studies, and literature reviews. Data about dexmedetomidine's indications, mechanisms of action, routes of administration, treatment outcomes, and adverse effects were included.

Results The review found that dexmedetomidine effectively reduces psychomotor agitation in patients with bipolar disorder, schizophrenia, and withdrawal syndromes, without severe sedation or respiratory depression. In alcohol withdrawal syndrome, dexmedetomidine safely managed autonomic hyperactivity and prevented progression to delirium tremens. Animal studies highlighted its potential to mitigate ADHD-like symptoms by reducing gut-brain axis inflammation, improving focus, and decreasing hyperactivity. Its anti-inflammatory and neuroprotective effects also showed promise in improving memory and reducing neuroinflammation in conditions like Alzheimer’s disease and depression. Additionally, in autism patients presenting with catatonia, dexmedetomidine provided acute stabilization.

Conclusions Dexmedetomidine demonstrates potential to reduce neurobehavioral manifestations in psychiatry while also providing a safer side effect profile. Dexmedetomidine was successful in managing psychomotor agitation, delirium in alcohol withdrawal syndrome, ADHD, and catatonia in autism. Additionally, dexmedetomidine's neuroprotective effects may have potential in improving neuroinflammatory disorders like Alzheimer’s disease and depression. Dexmedetomidine’s ability to effectively reduce sympathetic hyperactivity without significant side effect risk emphasizes its potential in psychiatric care.