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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

EMERGENCY MEDICINE DAY: MAY 27

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lunes, 5 de noviembre de 2018

Antipsychotics for delirium

PulmCrit(EMCrit)
PulmCrit - November 5, 2018 by Josh Farkas
..."Summary: The Bullet
  • MINDS-USA investigated the use of haloperidol or ziprasidone among a group of delirious ICU patients, 89% of whom had hypoactive delirium.
  • Haloperidol and ziprasidone were both ineffective. However, they were both also surprisingly safe (with comparable side-effect rates compared to placebo).
  • This study suggests that haloperidol and ziprasidone are ineffective for hypoactive delirium. This makes sense given the clinical features of hypoactive delirium (somnolence) and the variable neurobiological underpinnings of this disorder (making a single therapy unlikely to work for all patients).
  • All patients in the study were allowed to have open-label PRN antipsychotics for breakthrough agitation. Therefore, this study cannot reveal anything about this utilization of antipsychotics.
  • The receptor targets of atypical antipsychotics are widely variable. Thus, results obtained in this study are not necessarily generalizable to all antipsychotic medications."