What is the role of dexmedetomidine in the treatment of delirium tremens (DTs)?

Updated: Nov 06, 2020
  • Author: Michael James Burns, MD, FACEP, FACP, FIDSA; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Use of intravenous dexmedetomidine, an alpha-2 receptor antagonist with sedative and sympatholytic properties, is also an option for refractory DTs. It alleviates agitation, causes less respiratory depression, and may be given without mechanical ventilation, unlike propofol. It has been used with benzodiazepines as adjunctive therapy and may reduce total benzodiazepine dosage, but with the risk of producing bradycardia and hypotension. [24]  A 2015 review of English-language studies of dexmedetomidine for alcohol withdrawal, none of which was of high quality, found that dexmedetomidine appears to reduce benzodiazepine requirements and decreases sympathomimetic responses, but without convincing evidence that it improves clinical endpoints, including need for mechanical ventilation or length of stay. [25]


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