Atypical Antipsychotic Medications to Control Symptoms of Delirium in Children and Adolescents

Turkel, Susan Beckwitt; Jacobson, Julienne; Munzig, Elizabeth; Tavaré, C. Jane

doi:10.1089/cap.2011.0084

Cited by 72 publications

(58 citation statements)

References 23 publications

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“…Over the past decade, there have been increasing reports of delirium in critically ill infants, children, and adolescents (1,(5)(6)(7)(8)(9)(10)(11)(12)(13) as well reports on associated patient outcomes and financial implications (14)(15)(16). Over the past decade, there have been increasing reports of delirium in critically ill infants, children, and adolescents (1,(5)(6)(7)(8)(9)(10)(11)(12)(13) as well reports on associated patient outcomes and financial implications (14)(15)(16).…”

Section: Implementation Of An Icu Bundle: Anmentioning

confidence: 99%

Implementation of an ICU Bundle: An Interprofessional Quality Improvement Project to Enhance Delirium Management and Monitor Delirium Prevalence in a Single PICU*

Simone

Edwards

Lardieri

et al. 2017

Pediatric Critical Care Medicine

114

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Section: Implementation Of An Icu Bundle: Anmentioning

confidence: 99%

Implementation of an ICU Bundle: An Interprofessional Quality Improvement Project to Enhance Delirium Management and Monitor Delirium Prevalence in a Single PICU*

Simone

Edwards

Lardieri

et al. 2017

Pediatric Critical Care Medicine

114

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“…is determined (Turkel 2006). A recent retrospective study on the use of atypical antipsychotics in pediatric delirium (n=110, ages 1–18 years) found that olanzapine, quetiapine and risperidone were tolerated and all reduced symptoms based on the DRS, but efficacy and safety of the antipsychotics were not formally tested (Turkel 2012). …”

Section: Assessment/treatmentmentioning

confidence: 99%

Updates in paediatric psycho-oncology

Mavrides

Pao

2014

International Review of Psychiatry

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Childhood cancer accounts for less than 2% of all cancers diagnosed each year. About 12–14,000 children will be diagnosed in a given year with any type of cancer. Over the past fifty years, treatments and cure rates have improved from 10–20% five year survival rates to between 80–85% five year survival rates. Psychosocial support of children with cancer and their families has grown and has been more fully integrated into pediatric care over the past five decades. Increasing acceptance of the importance of addressing mental health has led to oncologists referring patients to specific resources and services. This paper provides updated information on psychosocial issues for those who treat children and adolescents with cancer and focuses on unique challenges for the pediatric psycho-oncologist.

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“…Both typical and atypical antipsychotics are used, with predominantly atypical antipsychotic use in children. 16,23,[25][26][27][28] There is limited data for their use in infant in whom congenital abnormalities, laboratory abnormalities, or multiple medications compound the risk for antipsychotic-induced QTc prolongation. Treating infants with these cardiac risk factors is challenging given the potential for arrhythmias with lethal consequences.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Delirium in Critically Ill Infants: Case Report and Review

Brahmbhatt

Whitgob

2016

Pediatrics

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Delirium in children is common but not widely understood by pediatric practitioners, often leading to underdiagnosis and lack of treatment. This presents a significant challenge in the young patients in the PICU who are most at risk for delirium and in whom the core features of delirium are difficult to assess and treat. However, because of the potential increased morbidity and mortality associated with untreated delirium in adults and children, it remains important to address it promptly. The literature for delirium in this age group is limited. Here we present the case of an infant with multiple underlying medical risk factors who exhibited waxing and waning motor restlessness with disrupted sleep-wake cycles contributing significantly to destabilization of vital parameters. Making a diagnosis of delirium was key to guiding further treatment. After appropriate environmental interventions are implemented and underlying medical causes are addressed, antipsychotic medications, although not Food and Drug Administration–approved in infants, are the mainstay of pharmacotherapy for delirium in older age groups. They may lengthen corrected QT interval (QTc) intervals, presenting a challenge in infants who frequently have other coexisting risks for QTc prolongation, as in our case. The risk from QTc prolongation needs to be balanced against that from untreated delirium. Low doses of risperidone were successfully used in this patient and without side effects or worsening of QTc interval. This case illustrates the importance of increased recognition of delirium in children, including infants, and the role for cautious consideration of atypical antipsychotics in the very young.

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Atypical Antipsychotic Medications to Control Symptoms of Delirium in Children and Adolescents

Abstract: Although randomized placebo-controlled studies are needed, atypical antipsychotic medications appeared to be effective and safe for managing delirium symptoms in pediatric patients while underlying etiology was addressed.

Cited by 72 publications

References 23 publications

Implementation of an ICU Bundle: An Interprofessional Quality Improvement Project to Enhance Delirium Management and Monitor Delirium Prevalence in a Single PICU*

Implementation of an ICU Bundle: An Interprofessional Quality Improvement Project to Enhance Delirium Management and Monitor Delirium Prevalence in a Single PICU*

Updates in paediatric psycho-oncology

Diagnosis and Management of Delirium in Critically Ill Infants: Case Report and Review

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