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Boettger, S; Jenewein, J; Breitbart, W.
Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effects.
Palliat Support Care. 2015; 13(4):1079-1085 Doi: 10.1017/S1478951514001059
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Co-authors Med Uni Graz
Jenewein Josef
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Abstract:
The aim of this study was to compare the efficacy and side-effect profile of the typical antipsychotic haloperidol with that of the atypical antipsychotics risperidone, olanzapine, and aripiprazole in the management of delirium. The Memorial Delirium Assessment Scale (MDAS), the Karnofsky Performance Status (KPS) scale, and a side-effect rating were recorded at baseline (T1), after 2-3 days (T2), and after 4-7 days (T3). Some 21 cases were case-matched by age, preexisting dementia, and baseline MDAS scores, and subsequently analyzed. The baseline characteristics of the medication groups were not different: The mean age of the patients ranged from 64.0 to 69.6 years, dementia was present in between 23.8 and 28.6%, and baseline MDAS scores were 19.9 (haloperidol), 18.6 (risperidone), 19.4 (olanzapine), and 18.0 (aripiprazole). The doses of medication at T3 were 5.5 mg haloperidol, 1.3 mg risperidone, 7.1 mg olanzapine, and 18.3 mg aripiprazole. Over one week, the decline in MDAS scores between medications was equal, and no differences between individual MDAS scores existed at T2 or T3. After one week, the MDAS scores were 6.8 (haloperidol), 7.1 (risperidone), 11.7 (olanzapine), and 8.3 (aripiprazole). At T2, delirium resolution occurred in 42.9-52.4% of cases and at T3 in 61.9-85.7%; no differences in assessments between medications existed. Recorded side effects were extrapyramidal symptoms (EPSs) in haloperidol- and risperidone-managed patients (19 and 4.8%, respectively) and sedation with olanzapine (28.6%). Haloperidol, risperidone, aripiprazole, and olanzapine were equally effective in the management of delirium; however, they differed in terms of their side-effect profile. Extrapyramidal symptoms were most frequently recorded with haloperidol, and sedation occurred most frequently with olanzapine.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Antipsychotic Agents - adverse effects
Antipsychotic Agents - pharmacology
Antipsychotic Agents - therapeutic use
Aripiprazole - adverse effects
Aripiprazole - pharmacology
Aripiprazole - therapeutic use
Benzodiazepines - adverse effects
Benzodiazepines - pharmacology
Benzodiazepines - therapeutic use
Delirium - drug therapy
Dementia - complications
Dementia - drug therapy
Female -
Haloperidol - adverse effects
Haloperidol - pharmacology
Haloperidol - therapeutic use
Humans -
Male -
Middle Aged -
Olanzapine -
Risperidone - adverse effects
Risperidone - pharmacology
Risperidone - therapeutic use

Find related publications in this database (Keywords)
Delirium
Aripiprazole
Haloperidol
Olanzapine
Risperidone
Antipsychotics
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