Real-world Survey of Clinical Experience using Dexmedetomidine Sublingual Film for Acute Agitation in over 200 Adults with Schizophrenia or Bipolar Disorder

Purpose: 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 without 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 treatment protocols and 10% severity assessment tools. No additional patient monitoring by 92%.

Patient response < 10 minutes in 66%. Outcomes were rapid treatment response, 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.

Conclusion: Real-world IGALMI™ DSF (dexmedetomidine sublingual film) experience treating agitation reported in over 200 adults with schizophrenia and bipolar disorder. Most patients self-administered DSF. Patient response was primarily < 10 minutes with targeted mechanism of action most important feature.

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 may assist clinicians initiating DSF therapy.