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Managing Agitation in Bipolar Disorder, Schizophrenia

— Leslie Citrome, MD, discusses data presented at the NEI Congress

Ƶ MedicalToday

During the , Leslie Citrome, MD, MPH, clinical professor of psychiatry and behavioral sciences at New York Medical College in Valhalla, discussed the current treatment paradigm for agitation in individuals with schizophrenia and bipolar disorder, as well as novel and investigational treatment options for the future.

In this exclusive Ƶ video, Citrome discusses new data presented by his group at the meeting in Colorado Springs, Colorado, regarding a recently approved treatment option for agitation in these patients.

Following is a transcript of his remarks:

I talked about the management of agitation associated with schizophrenia and bipolar disorder, talked about the various treatments that are available today regarding that.

There's a new one that was approved this year called dexmedetomidine sublingual film [Igalmi]. So, this is a treatment that is not an antipsychotic; it's actually a repurposed anesthetic agent. This anesthetic agent was approved over 20 years ago as an intravenous formulation. It was reformulated as a sublingual product by BioXcel, and tested as an anti-agitation agent at lower doses than what would be used for anesthesia. And it was found to work quite well in both patients with schizophrenia or bipolar disorder. Now, it was studied in bipolar disorder type I and type II in patients who were manic, hypomanic, or depressed -- didn't really matter [what phase of the illness they were in].

And there was also a poster presented at the meeting that examined the number needed to treat regarding the efficacy of dexmedetomidine sublingual film. And the overall effect size as measured by the number needed to treat [vs placebo] was three, which is pretty much the same number needed to treat versus placebo that we see for intramuscular injections of second-generation antipsychotics for treatment of agitation. So, here we have an oral formulation -- given by mouth, sublingually absorbed -- that is just as good as an injection. So, to me that's very interesting.

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