Dexmedetomidine-assisted drug interviews: an observation in psychiatric setting
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 favoura...
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| Published in: | BMJ case reports Vol. 11; no. 1; p. e227195 |
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| Format: | Journal Article |
| Language: | English |
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| Abstract | 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. |
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| AbstractList | 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. |
| Author | Garg, Harshit Carounagarane, Hamsenandinie Goswami, Devalina Deb, Koushik Sinha |
| AuthorAffiliation | 2 Department of Psychiatry , All India Institute of Medical Sciences , New Delhi , India 1 Anesthesiology, Pain Medicine and Critical Care , All India Institute of Medical Sciences, New Delhi, India , New Delhi , Delhi , India |
| AuthorAffiliation_xml | – name: 1 Anesthesiology, Pain Medicine and Critical Care , All India Institute of Medical Sciences, New Delhi, India , New Delhi , Delhi , India – name: 2 Department of Psychiatry , All India Institute of Medical Sciences , New Delhi , India |
| Author_xml | – sequence: 1 givenname: Devalina surname: Goswami fullname: Goswami, Devalina email: harshit_medical@yahoo.com organization: Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India, New Delhi, Delhi, India – sequence: 2 givenname: Harshit orcidid: 0000-0002-9720-627X surname: Garg fullname: Garg, Harshit email: harshit_medical@yahoo.com organization: Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India – sequence: 3 givenname: Hamsenandinie surname: Carounagarane fullname: Carounagarane, Hamsenandinie email: harshit_medical@yahoo.com organization: Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India, New Delhi, Delhi, India – sequence: 4 givenname: Koushik Sinha surname: Deb fullname: Deb, Koushik Sinha email: harshit_medical@yahoo.com organization: Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30567267$$D View this record in MEDLINE/PubMed |
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| Copyright | BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ. 2018 BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ. BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ. 2018 |
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| Keywords | anxiety disorders (including ocd and ptsd) drugs: psychiatry anaesthesia |
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| References | Lee, Park, Park 2011; 8 Weerink, Struys, Hannivoort 2017; 56 Naples, Hackett 1978; 19 Brand 2012; 13 Sessler, Grap, Ramsay 2008; 12 Shetty, Bellini, Wijayatilake 2018; 2 Harrington, Jackimczyk, Seligson 1990; 19 Seo, Shin, Kim 2013; 8 2011; 12 Naaz, Ozair 2014; 8 Kaur, Singh 2011; 5 Nichols, Zasler, Martelli 2012; 31 Lambert, Rees 1944; 2 Mushtaq, Shoib, Arif 2014; 2014 Ramsay, Savege, Simpson 1974; 2 Scott-Warren, Sebastian 2016; 16 International Society for the Study of Trauma and Dissociation (key-10.1136/bcr-2018-227195-1) 2011; 12 Naples (key-10.1136/bcr-2018-227195-3) 1978; 19 Brand (key-10.1136/bcr-2018-227195-4) 2012; 13 Ramsay (key-10.1136/bcr-2018-227195-12) 1974; 2 Nichols (key-10.1136/bcr-2018-227195-2) 2012; 31 Harrington (key-10.1136/bcr-2018-227195-6) 1990; 19 Shetty (key-10.1136/bcr-2018-227195-13) 2018; 2 Scott-Warren (key-10.1136/bcr-2018-227195-15) 2016; 16 Weerink (key-10.1136/bcr-2018-227195-16) 2017; 56 Lambert (key-10.1136/bcr-2018-227195-5) 1944; 2 Seo (key-10.1136/bcr-2018-227195-9) 2013; 8 Naaz (key-10.1136/bcr-2018-227195-10) 2014; 8 Sessler (key-10.1136/bcr-2018-227195-11) 2008; 12 Lee (key-10.1136/bcr-2018-227195-7) 2011; 8 Kaur (key-10.1136/bcr-2018-227195-14) 2011; 5 Mushtaq (key-10.1136/bcr-2018-227195-8) 2014; 2014 |
| References_xml | – volume: 5 start-page: 128 year: 2011 article-title: Current role of dexmedetomidine in clinical anesthesia and intensive care publication-title: Anesth Essays Res doi: 10.4103/0259-1162.94750 contributor: fullname: Singh – volume: 19 start-page: 98 year: 1978 article-title: The amytal interview: history and current uses publication-title: Psychosomatics doi: 10.1016/S0033-3182(78)71020-0 contributor: fullname: Hackett – volume: 2 start-page: CD011240 year: 2018 article-title: BIS monitoring versus clinical assessment for sedation in mechanically ventilated adults in the intensive care unit and its impact on clinical outcomes and resource utilization publication-title: Cochrane Database Syst Rev doi: 10.1002/14651858.CD011240.pub2 contributor: fullname: Wijayatilake – volume: 13 start-page: 387 year: 2012 article-title: What we know and what we need to learn about the treatment of dissociative disorders publication-title: J Trauma Dissociation doi: 10.1080/15299732.2012.672550 contributor: fullname: Brand – volume: 16 start-page: 242 year: 2016 article-title: Dexmedetomidine: its use in intensive care medicine and anaesthesia publication-title: BJA Educ doi: 10.1093/bjaed/mkv047 contributor: fullname: Sebastian – volume: 19 start-page: 941 year: 1990 article-title: Thiopental-facilitated interview in respiratory Munchausen’s syndrome publication-title: Ann Emerg Med doi: 10.1016/S0196-0644(05)81576-8 contributor: fullname: Seligson – volume: 8 start-page: GE01 year: 2014 article-title: Dexmedetomidine in current anaesthesia practice- a review publication-title: J Clin Diagn Res doi: 10.7860/JCDR/2014/9624.4946 contributor: fullname: Ozair – volume: 31 start-page: 95 year: 2012 article-title: Sodium amobarbital: historical perspectives and neurorehabilitation clinical caveats publication-title: NeuroRehabilitation doi: 10.3233/NRE-2012-0778 contributor: fullname: Martelli – volume: 8 start-page: 377 year: 2011 article-title: Use of Lorazepam in drug-assisted interviews: two cases of dissociative amnesia publication-title: Psychiatry Investig doi: 10.4306/pi.2011.8.4.377 contributor: fullname: Park – volume: 12 start-page: S2 year: 2008 article-title: Evaluating and monitoring analgesia and sedation in the intensive care unit publication-title: Crit Care doi: 10.1186/cc6148 contributor: fullname: Ramsay – volume: 56 start-page: 893 year: 2017 article-title: Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine publication-title: Clin Pharmacokinet doi: 10.1007/s40262-017-0507-7 contributor: fullname: Hannivoort – volume: 2014 start-page: 1 year: 2014 article-title: First reported case of lorazepam-assisted interview in a young indian female presenting with dissociative identity disorder and improvement in symptoms after the interview publication-title: Case Rep Psychiatry doi: 10.1155/2014/346939 contributor: fullname: Arif – volume: 8 start-page: 186 year: 2013 article-title: Effectiveness of lorazepam-assisted interviews in an adolescent with dissociative amnesia: a case report publication-title: Neural Regen Res doi: 10.3969/j.issn.1673-5374.2013.02.012 contributor: fullname: Kim – volume: 2 start-page: 70 year: 1944 article-title: Intravenous barbiturates in treatment of hysteria publication-title: Br Med J doi: 10.1136/bmj.2.4358.70 contributor: fullname: Rees – volume: 2 start-page: 656 year: 1974 article-title: Controlled sedation with alphaxalone-alphadolone publication-title: Br Med J doi: 10.1136/bmj.2.5920.656 contributor: fullname: Simpson – volume: 12 start-page: 115 year: 2011 article-title: Guidelines for treating dissociative identity disorder in adults, third revision publication-title: J Trauma Dissociation doi: 10.1080/15299732.2011.537247 – volume: 8 start-page: 186 year: 2013 ident: key-10.1136/bcr-2018-227195-9 article-title: Effectiveness of lorazepam-assisted interviews in an adolescent with dissociative amnesia: a case report publication-title: Neural Regen Res contributor: fullname: Seo – volume: 8 start-page: 377 year: 2011 ident: key-10.1136/bcr-2018-227195-7 article-title: Use of Lorazepam in drug-assisted interviews: two cases of dissociative amnesia publication-title: Psychiatry Investig doi: 10.4306/pi.2011.8.4.377 contributor: fullname: Lee – volume: 5 start-page: 128 year: 2011 ident: key-10.1136/bcr-2018-227195-14 article-title: Current role of dexmedetomidine in clinical anesthesia and intensive care publication-title: Anesth Essays Res doi: 10.4103/0259-1162.94750 contributor: fullname: Kaur – volume: 13 start-page: 387 year: 2012 ident: key-10.1136/bcr-2018-227195-4 article-title: What we know and what we need to learn about the treatment of dissociative disorders publication-title: J Trauma Dissociation doi: 10.1080/15299732.2012.672550 contributor: fullname: Brand – volume: 2 start-page: 70 year: 1944 ident: key-10.1136/bcr-2018-227195-5 article-title: Intravenous barbiturates in treatment of hysteria publication-title: Br Med J doi: 10.1136/bmj.2.4358.70 contributor: fullname: Lambert – volume: 2 start-page: CD011240 year: 2018 ident: key-10.1136/bcr-2018-227195-13 article-title: BIS monitoring versus clinical assessment for sedation in mechanically ventilated adults in the intensive care unit and its impact on clinical outcomes and resource utilization publication-title: Cochrane Database Syst Rev contributor: fullname: Shetty – volume: 12 start-page: 115 year: 2011 ident: key-10.1136/bcr-2018-227195-1 article-title: Guidelines for treating dissociative identity disorder in adults, third revision publication-title: J Trauma Dissociation doi: 10.1080/15299732.2011.537247 contributor: fullname: International Society for the Study of Trauma and Dissociation – volume: 8 start-page: GE01 year: 2014 ident: key-10.1136/bcr-2018-227195-10 article-title: Dexmedetomidine in current anaesthesia practice- a review publication-title: J Clin Diagn Res contributor: fullname: Naaz – volume: 56 start-page: 893 year: 2017 ident: key-10.1136/bcr-2018-227195-16 article-title: Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine publication-title: Clin Pharmacokinet doi: 10.1007/s40262-017-0507-7 contributor: fullname: Weerink – volume: 31 start-page: 95 year: 2012 ident: key-10.1136/bcr-2018-227195-2 article-title: Sodium amobarbital: historical perspectives and neurorehabilitation clinical caveats publication-title: NeuroRehabilitation doi: 10.3233/NRE-2012-0778 contributor: fullname: Nichols – volume: 19 start-page: 98 year: 1978 ident: key-10.1136/bcr-2018-227195-3 article-title: The amytal interview: history and current uses publication-title: Psychosomatics doi: 10.1016/S0033-3182(78)71020-0 contributor: fullname: Naples – volume: 19 start-page: 941 year: 1990 ident: key-10.1136/bcr-2018-227195-6 article-title: Thiopental-facilitated interview in respiratory Munchausen’s syndrome publication-title: Ann Emerg Med doi: 10.1016/S0196-0644(05)81576-8 contributor: fullname: Harrington – volume: 2014 start-page: 1 year: 2014 ident: key-10.1136/bcr-2018-227195-8 article-title: First reported case of lorazepam-assisted interview in a young indian female presenting with dissociative identity disorder and improvement in symptoms after the interview publication-title: Case Rep Psychiatry contributor: fullname: Mushtaq – volume: 16 start-page: 242 year: 2016 ident: key-10.1136/bcr-2018-227195-15 article-title: Dexmedetomidine: its use in intensive care medicine and anaesthesia publication-title: BJA Educ doi: 10.1093/bjaed/mkv047 contributor: fullname: Scott-Warren – volume: 12 start-page: S2 year: 2008 ident: key-10.1136/bcr-2018-227195-11 article-title: Evaluating and monitoring analgesia and sedation in the intensive care unit publication-title: Crit Care doi: 10.1186/cc6148 contributor: fullname: Sessler – volume: 2 start-page: 656 year: 1974 ident: key-10.1136/bcr-2018-227195-12 article-title: Controlled sedation with alphaxalone-alphadolone publication-title: Br Med J doi: 10.1136/bmj.2.5920.656 contributor: fullname: Ramsay |
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| SubjectTerms | 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 |
| Title | Dexmedetomidine-assisted drug interviews: an observation in psychiatric setting |
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