Comparative efficacy study of haloperidol, olanzapine and risperidone in delirium

Grover, Sandeep; Kumar, Vineet; Chakrabarti, Subho

doi:10.1016/j.jpsychores.2011.01.019

Cited by 109 publications

(102 citation statements)

References 23 publications

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“…Similar results have been demonstrated in smaller, non-placebo-controlled studies with amisulpride [90], quetiapine [90,91], and risperidone [92,93]. Recently, a prospective, single-blind, randomized controlled trial compared the efficacy and safety of haloperidol, olanzapine, and risperidone in the treatment of delirium with 20 to 23 patients in each arm of the study [94]. It showed that risperidone and olanzapine were as efficacious as haloperidol, with significant improvement in DRS-R98 severity scores and lower mini-mental status exam (MMSE) scores in all three groups.…”

Section: Atypical Anti-psychoticssupporting

confidence: 64%

Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients

2012

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Delirium is a common yet under-diagnosed syndrome of acute brain dysfunction, which is characterized by inattention, fluctuating mental status, altered level of consciousness, or disorganized thinking. Although our recognition of risk factors for delirium has progressed, our understanding of the underlying pathophysiologic mechanisms remains limited. Improvements in monitoring and assessment for delirium (particularly in the intensive care setting) have resulted in validated and reliable tools such as arousal scales and bedside delirium monitoring instruments. Once delirium is recognized and the modifiable risk factors are addressed, the next step in management (if delirium persists) is often pharmacological intervention. The sedatives, analgesics, and hypnotics most often used in the intensive care unit (ICU) to achieve patient comfort are all too frequently deliriogenic, resulting in a longer duration of ICU and hospital stay, and increased costs. Therefore, identification of safe and efficacious agents to reduce the incidence, duration, and severity of ICU delirium is a hot topic in critical care. Recognizing that there are no medications approved by the Food and Drug Administration (FDA) for the prevention or treatment of delirium, we chose anti-psychotics and alpha-2 agonists as the general pharmacological focus of this article because both were subjects of relatively recent data and ongoing clinical trials. Emerging pharmacological strategies for addressing delirium must be combined with nonpharmacological approaches (such as daily spontaneous awakening trials and spontaneous breathing trials) and early mobility (combined with the increasingly popular approach called: Awakening and Breathing Coordination, Delirium Monitoring, Early Mobility, and Exercise [ABCDE] of critical care) to develop evidence-based approaches that will ensure safer and faster recovery of the sickest patients in our healthcare system.

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Section: Atypical Anti-psychoticssupporting

confidence: 64%

Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients

2012

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“…Despite the differences in delirium etiology for each group, the final K-DRS-98 or MMSE scores were similar 7 days after diagnosis. Other studies reported common underlying etiologies of delirium, such as fracture, metabolic disturbance, or endocrine disturbance [19,20]. These inconsistent findings reflect the varying clinical settings from each study, suggesting that the etiologies of delirium need to be investigated in larger samples.…”

Section: Discussionmentioning

confidence: 86%

“…Typical antipsychotics, primarily haloperidol, have been used empirically to control symptoms of delirium. Recently, researchers have begun reporting that atypical antipsychotics, such as olanzapine, quetiapine, and risperidone, might be as effective as haloperidol in delirium treatment [10,11,18,19].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Antipsychotics on Delirium in Elderly Patients

Lee¹,

Kim²,

Ahn³

et al. 2017

J Psychiatry

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“…4,7,21 Atypical antipsychotics, such as risperidone, olanzapine, quetiapine, and ziprasidone, among others, can be equally useful in the treatment of the physical signs of delirium in children. 4,7,16,19,23,27,[42][43][44][45] In studies in adults, 4,19,[46][47][48] these medications have had efficacy similar to that of haloperidol, but with fewer side effects. These agents also have an effect on dopamine activity, along with more extensive effects on acetylcholine, serotonin, and norepinephrine receptors.…”

Section: Pharmacological Management Of Deliriummentioning

confidence: 99%

Delirium in Children: Identification, Prevention, and Management

Bettencourt

Mullen

2017

Critical Care Nurse

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Delirium in children is an often underrecognized but serious complication of hospitalization. Delirium in this age group has been described as behaviors such as refractory agitation and restlessness, visual or auditory hallucinations, children being "not themselves," and a lethargic state. Often, children with delirium are at risk for harming themselves by dislodging tubes, falling, or refusing care. Pediatric nurses must recognize and intervene to prevent and treat delirium in hospitalized children because the delirium may be an indicator of worsening clinical status and is associated with high mortality and morbidity in children of all ages and with posttraumatic stress disorder. Pediatric nurses are uniquely positioned to design care interventions to both reduce risk for delirium and treat active delirium. Many treatment recommendations are nonpharmacological and are part of excellent nursing care. (Critical Care Nurse. 2017; 37[3]:e9-e18)

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Comparative efficacy study of haloperidol, olanzapine and risperidone in delirium

Cited by 109 publications

References 23 publications

Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients

Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients

Effectiveness of Antipsychotics on Delirium in Elderly Patients

Delirium in Children: Identification, Prevention, and Management

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