How do you transition severely agitated ICU patients off a dexmedetomidine infusion when it is being used primarily for psychiatric agitation?  

What tapering strategy do you use for dexmedetomidine (Precedex) when it is being used for agitation rather than for sedation in critical illness? Do you use IV haloperidol during the taper to prevent recurrence of agitation— and if so, how do you approach timing and scheduling? Is there a role for alpha-2 agonist bridging (e.g., clonidine) in this setting?