2024 15th Annual NUBE Conference

Background: Agitation treatment in patients with schizophrenia or bipolar disorder is challenging. Alpha-2 agonist, IGALMI^™ DSF (dexmedetomidine sublingual film) reduces norepinephrine. Real-world survey data from over 200 DSF-treated patients reported in the absence of existing publications.
Methods: Consolidated results from 2 surveys (one year apart) with 35 total questions sent to 80 clinicians from 30 institutions.
Results: Twenty-two respondents treating over 200 patients with DSF in multiple clinical settings. Most important feature was targeted mechanism of action. Starting doses equally 180-mcg and 120-mcg with 33% multiple times weekly. Impaired patients treated, and most self-administered. Only 20% used agitation protocols and 10% severity assessment tools. No additional patient monitoring required by 92% of respondents.
Patient response time <10 minutes in 66%. Outcomes were rapid treatment response and decreased IM injections, staff Injury, physical restraint use, treatment-related adverse effects, and benzodiazepine use.
Compared to oral benzodiazepines/antipsychotics, 75% rated DSF treatment speed as much better or somewhat better. Compared to injectable options, 53% rated DSF treatment speed as much better or somewhat better. Clinician and patient satisfaction ratings were very favorable.
Lessons Learned: Real-world IGALMI^™ DSF (dexmedetomidine sublingual film) experience treating agitation reported in over 200 adults with schizophrenia and bipolar disorder. Most patients self-administered with 180-mcg or 120-mcg. Patient response was <10 minutes in most patients with targeted mechanism of action feature rated highest.
Outcomes were rapid treatment response and decreased IM injections, staff injuries, physical restraint use, treatment-related adverse effects, and benzodiazepine use. This real-world data can assist clinicians initiating DSF therapy.

Learning Objectives:

Understand real-world experience with new treatment option for acute management of agitation in schizophrenia or bipolar disorder

Identify observed outcomes and patient benefits with dexmedetomidine sublingual film

Understand early clinician experience with current medications for managing agitation