Successful treatment of acute mania and perineal abscess using dexmedetomidine sedation as adjunctive therapy

Acute psychiatric illness with agitation presents the clinician with a dangerous, potentially life-threatening situation often requiring complex management. Alteration in patients’ insight and judgment may result in medication non-compliance, potentially further complicating therapy directed at the primary psychiatric illness as well as any co-existing conditions. Sedation is often necessary to control dangerous behaviour during the period of antipsychotic and mood-stabilising drug titration. Dexmedetomidine is a centrally acting selective α2-adrenergic agonist with anaesthetic and sedative properties widely used in intensive care units for sedation in critically ill patients. The authors report the case of a patient managed successfully with dexmedetomidine sedation while being treated for acute mania and perineal abscess.