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Bipolar DisorderFebruary 2022Summary reviewed June 2026

What Researchers Found Testing Dexmedetomidine for Bipolar Agitation

Scientists tested a film that dissolves under the tongue containing dexmedetomidine in 380 adults experiencing agitation from bipolar disorder. Both doses tested reduced agitation scores significantly more than placebo within 20 minutes, with effects lasting at least 2 hours.

What the trial was testing

The trial enrolled 380 patients with bipolar disorder. The study was sponsored by BioXcel Therapeutics Inc and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

Agitation scores dropped 5.4 points more with the higher dose compared to placebo at 2 hours.

JAMA · 2022 · NCT04276883

These findings — that the higher dose reduced agitation significantly more than placebo within 2 hours — were published in the JAMA and represent the headline result of the study.

Researchers tracked outcomes across 380 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with bipolar disorder, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

This was a large-scale study and the results were positive. In April 2022, the FDA approved this sublingual film (brand name Igalmi) specifically for acute agitation in adults with bipolar disorder or schizophrenia. If you experience severe agitation episodes, ask your doctor whether this fast-acting treatment might be appropriate for you.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open bipolar disorder trials