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Efficacy and safety of haloperidol versus atypical antipsychotic medications in the treatment of delirium

Authors
 Hyung-Jun Yoon  ;  Kyoung-Min Park  ;  Won-Jung Choi  ;  Soo-Hee Choi  ;  Jin-Young Park  ;  Jae-Jin Kim  ;  Jeong-Ho Seok 
Citation
 BMC PSYCHIATRY, Vol.13 : 240, 2013 
Journal Title
BMC PSYCHIATRY
Issue Date
2013
MeSH
Aged ; Antipsychotic Agents/adverse effects ; Antipsychotic Agents/therapeutic use* ; Benzodiazepines/adverse effects ; Benzodiazepines/therapeutic use* ; Delirium/drug therapy* ; Dibenzothiazepines/adverse effects ; Dibenzothiazepines/therapeutic use* ; Female ; Haloperidol/adverse effects ; Haloperidol/therapeutic use* ; Humans ; Male ; Middle Aged ; Prospective Studies ; Quetiapine Fumarate ; Risperidone/adverse effects ; Risperidone/therapeutic use* ; Treatment Outcome
Keywords
Delirium ; Haloperidol ; Risperidone ; Olanzapine ; Quetiapine
Abstract
BACKGROUND:
Most previous studies on the efficacy of antipsychotic medication for the treatment of delirium have reported that there is no significant difference between typical and atypical antipsychotic medications. It is known, however, that older age might be a predictor of poor response to antipsychotics in the treatment of delirium. The objective of this study was to compare the efficacy and safety of haloperidol versus three atypical antipsychotic medications (risperidone, olanzapine, and quetiapine) for the treatment of delirium with consideration of patient age.
METHODS:
This study was a 6-day, prospective, comparative clinical observational study of haloperidol versus atypical antipsychotic medications (risperidone, olanzapine, and quetiapine) in patients with delirium at a tertiary level hospital. The subjects were referred to the consultation-liaison psychiatric service for management of delirium and were screened before enrollment in this study. A total of 80 subjects were assigned to receive either haloperidol (N = 23), risperidone (N = 21), olanzapine (N = 18), or quetiapine (N = 18). The efficacy was evaluated using the Korean version of the Delirium Rating Scale-Revised-98 (DRS-K) and the Korean version of the Mini Mental Status Examination (K-MMSE). The safety was evaluated by the Udvalg Kliniske Undersogelser side effect rating scale.
RESULTS:
There were no significant differences in mean DRS-K severity or K-MMSE scores among the four groups at baseline. In all groups, the DRS-K severity score decreased and the K-MMSE score increased significantly over the study period. However, there were no significant differences in the improvement of DRS-K or K-MMSE scores among the four groups. Similarly, cognitive and non-cognitive subscale DRS-K scores decreased regardless of the treatment group. The treatment response rate was lower in patients over 75 years old than in patients under 75 years old. Particularly, the response rate to olanzapine was poorer in the older age group. Fifteen subjects experienced a few adverse events, but there were no significant differences in adverse event profiles among the four groups.
CONCLUSIONS:
Haloperidol, risperidone, olanzapine, and quetiapine were equally efficacious and safe in the treatment of delirium. However, age is a factor that needs to be considered when making a choice of antipsychotic medication for the treatment of delirium.
Files in This Item:
T201303443.pdf Download
DOI
10.1186/1471-244X-13-240
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jae Jin(김재진) ORCID logo https://orcid.org/0000-0002-1395-4562
Park, Kyoung Min(박경민)
Park, Jin Young(박진영) ORCID logo https://orcid.org/0000-0002-5351-9549
Seok, Jeong Ho(석정호) ORCID logo https://orcid.org/0000-0002-9402-7591
Yoon, Hyung Jun(윤형준)
Choi, Soo Hee(최수희)
Choi, Won Jung(최원정)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88080
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