Delirium treatment in intoxicated patients in ICU: A randomized, double-blind clinical trial
نویسندگان
1 Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
5 Toxicological Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7 Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 2Toxicological Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
doi
10.34172/jept.2020.41چکیده
Objective: Delirium is one of the most common complications in patients admittedto intensive care units (ICUs). Delirium is a definite cause for more extended hospitalstays, higher mortality rates, and possibly persistent cognitive decline in the future.Antipsychotics have been frequently evaluated as first drugs of choice, but the mostappropriate, evidence-based treatment is yet to be discovered. This study aims to comparethe efficacy of haloperidol and olanzapine in patients admitted to our toxicology ICU.Methods: This double-blind, randomized controlled clinical trial was undertaken on 35 ICUadmitted patients with delirium in Loghman Hakim hospital in Tehran, Iran. The diagnosiswas based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-V) criteria for delirium, and clinical toxicologists included the patients accordingto the study’s inclusion and exclusion criteria. Patients received either haloperidol orolanzapine based on computerized randomization. The severity of delirium was measuredwith 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 19patients received olanzapine. The doses of haloperidol and olanzapine were 3 mg threetimes a day and 5 mg three times a day, respectively. There was no significant difference inbaseline characteristics and the scores of MDAS between groups.Conclusion: Olanzapine and haloperidol have the same efficacy in the managementof delirium in toxicology ICU-admitted patients. They can be interchangeably used fordelirium treatment in these patients
