Aripiprazole in the treatment of delirium
ABSTRACT Delirium is a common condition frequently seen in consultation-liaison psychiatry. It is especially common among medically compromised patients, and is an indicator of the severity of the medical illness. In addition, it is associated with a higher morbidity, mortality, and longer hospitalization. Traditionally, haloperidol has been used to treat agitation as it may occur in delirium. However, atypical antipsychotics are being increasingly used to treat delirium.
In this article, we will describe two cases of delirium successfully treated with aripiprazole.
Both patients had significant improvement in their delirium as measured by the delirium rating scale.
Aripiprazole appears to be effective in reducing the symptoms of delirium.
Full-textDOI: · Available from: Marvin Koss, Aug 20, 2015
- SourceAvailable from: Elizabeth L Sampson
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- "Similar responses to quetiapine and amisulpiride were reported in an open randomized prospective study . Aripiprazole has also been reported in case reports   and a case series  to be of benefit in treating delirium. Comparative studies of haloperidol and atypical antipsychotics have failed to identify evidence of any advantage in terms of clinical efficacy    . "
ABSTRACT: The aim of this review was to summarize and critically evaluate the current literature regarding the safety and efficacy of drug therapy in delirium. We also identified recent research developments and highlighted some ongoing clinical trials to explore future directions in drug treatment and prevention of delirium. We conducted a literature search of Medline, Embase, PsychInfo, and Cochrane Review databases, which included both prospective and retrospective clinical trials and case studies on delirium and drug therapy in adult patients up to March 2008. Abstracts from recent topical conferences were also reviewed. Ongoing delirium drug studies were identified via the WHO International Clinical Trials Registry Platform Search Portal, accessed March 12, 2008. The evidence base for effective drug treatment of delirium is restricted by limitations in many of the studies conducted to date. However, there has been an increase in the quantity and quality of delirium drug studies in recent years; preliminary reports and ongoing studies add to this trend. Although efficacy rates between typical and atypical antipsychotic agents are similar, the latter are associated with fewer extrapyramidal side effects. Prophylactic interventions with antipsychotic and cholinesterase inhibitors in high-risk patients provide an opportunity to improve postoperative patient care. Alternative techniques and medication opportunities could be explored in attempts to minimize drug induced delirium potential. Appropriate drug therapy should be considered part of systematic approaches to delirium treatment and prevention. There is a need for well-designed randomized, double-blind placebo-controlled trials investigating the drug management of various aspects of delirium, including delineating treatment by delirium subtype, dose ranging studies, and optimal duration of therapy.Journal of Psychosomatic Research 10/2008; 65(3):273-82. DOI:10.1016/j.jpsychores.2008.05.025 · 2.84 Impact Factor
Article: Delirium in palliative care[Show abstract] [Hide abstract]
ABSTRACT: Delirium is highly prevalent in cancer patients with advanced disease. Frequently a preterminal event, the condition is a sign of significant physiologic disturbance, typically involving multiple medical etiologies including infection, organ failure, adverse medication effects, and in rare situations, paraneoplastic syndromes. Unfortunately, delirium is frequently unrecognized or misdiagnosed and, therefore, inappropriately treated or untreated in terminally ill patients. The clinical features of delirium are numerous and encompass a variety of neuropsychiatric symptoms common to other psychiatric disorders. Three clinical subtypes of delirium, based on arousal disturbance and psychomotor behavior, have been described: hyperactive, hypoactive, and mixed. The differential diagnosis for delirium includes depression, mania, psychosis, and dementia. Numerous instruments have been developed to aid the clinician in rapidly screening for the disorder. Standard management requires an investigation of the etiologies, correction of the contributing factors, and management of symptoms. Symptomatic and supportive therapies, including numerous pharmacologic approaches, are important, but several aspects of the use of neuroleptics and other agents in the management of delirium in the dying patient remain controversial.Oncology (Williston Park, N.Y.) 11/2004; 18(12):1541-50; discussion 1551-3. · 2.98 Impact Factor
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