Dexmedetomidine-assisted drug interviews: an observation in psychiatric setting

• Published in: BMJ case reports Vol. 11; no. 1; p. e227195
• Main Authors: Goswami, Devalina, Garg, Harshit, Carounagarane, Hamsenandinie, Deb, Koushik Sinha
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-12-2018; BMJ Publishing Group
• Series: Case Report
• Subjects: Adolescent; Anesthesia; Anxiety disorders; Aphonia - diagnosis; Aphonia - psychology; Blindness - diagnosis; Blindness - psychology; Blood pressure; Case reports; Comorbidity; Conscious Sedation - methods; Dexmedetomidine - therapeutic use; Dissociative Disorders - diagnosis; Drug dosages; Female; Headaches; Humans; Hypnotics and Sedatives - therapeutic use; Intensive care; Interviews; Interviews as Topic; Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation); Patients; Psychotherapy; Respiration, Artificial; Thiopental - therapeutic use; Treatment Outcome; Visual impairment; Young Adult; anxiety disorders (including ocd and ptsd); drugs: psychiatry; anaesthesia
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-227195

Drug-assisted interviews are an effective tool in the management of various psychiatric illnesses where psychopharmacological, as well as routine psychological interventions, do not prove beneficial. These have most commonly been done by using barbiturates and benzodiazepines that have given favourable results for a long time. However, they carry the risk of respiratory depression and difficulty in maintaining the plane of sedation where the patient is amenable to interviewing. In our experience of drug-assisted interviews with two patients we used intravenous dexmedetomidine, which is being used in anaesthesia practice for conscious sedation or sedation in the intensive care unit. We found dexmedetomidine to be superior to thiopentone in achieving a level of conscious sedation where the patients were amenable for an interview, with no significant adverse events and faster post-anaesthetic recovery.