Ef(cid:976)icacy and Safety of Antipsychotic Medications in
the Treatment of Delirium
1 Department of Psychiatry, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
Affiliation :
Veevarin Charoenporn MD1
Objective : To examine the therapeutic effects and adverse events in patients with delirium after treatment by antipsychotics, which
are haloperidol, risperidone, and quetiapine.
Materials and Methods: Fifty-six delirious inpatients treated by haloperidol, risperidone, and quetiapine participated in this
study. The type and dosage of medication depended on the judgment of psychiatrists who took care of each patient. Investigators
observed the clinical progression without being involved in any treatment methods. Severity of delirium was evaluated using the
Memorial Delirium Assessment Scale [MDAS]. The extrapyramidal side effect [EPS] was assessed via the Modi(cid:976)ied Simpson-Angus
Scale [MSAS]. All measures were applied at the baseline (prior to the treatment) and repeated daily throughout the 7-day study.
The mixed model regression analysis was used.
Results : Eleven (19.6%), 14 (25%), and 31 (55.4%) participants received haloperidol, risperidone, and quetiapine, respectively.
At baseline, MDAS score (mean) of haloperidol, risperidone, and quetiapine groups were 14.5, 19.3, and 18.0, which were not
statistical different. At study end, the MDAS score improved the most in risperidone group (-8.3), followed by haloperidol (-7.3), and
quetiapine group (-5.9). The mixed model analysis indicated no signi(cid:976)icant differences in the improving scores between treatment
groups. About 30% of patients had experienced adverse events. Most common side effects were sedation (14.3%) and EPS (10.7%).
There were no statistical signi(cid:976)icant differences in side effect pro(cid:976)iles between groups.
Conclusion : Haloperidol, risperidone, and quetiapine are similarly effective in the management of delirium. No different side-effect
pro(cid:976)ile was found.
Keywords : Ef(cid:976)icacy, Safety, Delirium, Antipsychotics, Haloperidol, Risperidone, Quetiapine, Extrapyramidal side effect [EPS]
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