Journal of Emergency Practice and Trauma

Delirium treatment in intoxicated patients in ICU: A randomized, double-blind clinical trial

Document Type : Original Article

Authors

Javad Mesbahi 1
Shahin Shadnia 2
Hossein Hassanian-Moghaddam 3, 1
Nasim Zamani 3, 1
Peyman Erfan Talab Evini 4
Delara Hazegh Fetratjoo 5
Alireza Kargar 6
Mitra Rahimi 2

1 Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Toxicological Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 2Toxicological Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

6 Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

https://doi.org/10.34172/jept.2020.41
Abstract
Objective: Delirium is one of the most common complications in patients admitted
to intensive care units (ICUs). Delirium is a definite cause for more extended hospital
stays, higher mortality rates, and possibly persistent cognitive decline in the future.
Antipsychotics have been frequently evaluated as first drugs of choice, but the most
appropriate, evidence-based treatment is yet to be discovered. This study aims to compare
the efficacy of haloperidol and olanzapine in patients admitted to our toxicology ICU.
Methods: This double-blind, randomized controlled clinical trial was undertaken on 35 ICU
admitted patients with delirium in Loghman Hakim hospital in Tehran, Iran. The diagnosis
was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
(DSM-V) criteria for delirium, and clinical toxicologists included the patients according
to the study’s inclusion and exclusion criteria. Patients received either haloperidol or
olanzapine based on computerized randomization. The severity of delirium was measured
with the Memorial Delirium Assessment Scale (MDAS) scoring on days 0 and 3 of ICUadmission.
Results: The total sample size was 35 in which 16 patients received haloperidol, and 19
patients received olanzapine. The doses of haloperidol and olanzapine were 3 mg three
times a day and 5 mg three times a day, respectively. There was no significant difference in
baseline characteristics and the scores of MDAS between groups.
Conclusion: Olanzapine and haloperidol have the same efficacy in the management
of delirium in toxicology ICU-admitted patients. They can be interchangeably used for
delirium treatment in these patients

Keywords

Delirium
Haloperidol
Olanzapine
Toxicology
Intensive care unit
Subjects
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Journal of Emergency Practice and Trauma
Volume 7, Issue 2
July 2021
Pages 93-96

  • Receive Date 17 July 2020
  • Revise Date 02 October 2020
  • Accept Date 11 October 2020

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