Aripiprazole and haloperidol in the treatment of delirium
Aripiprazole and haloperidol in the treatment of delirium
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DOI：
10.3109/00048674.2011.543411
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发表时间：
2011-06-01
影响因子：
4.6
通讯作者：
Passik, Steven
中科院分区：
文献类型：
--
作者：
Boettger, Soenke;Friedlander, Miriam;Passik, Steven
目的：比较阿立哌唑和氟哌啶醇在改善谵妄及其运动亚型的痛苦症状方面的疗效和耐受性。方法：在纪念斯隆-凯特琳癌症中心，我们前瞻性地收集了社会人口统计学和医学数据，并使用纪念性谵妄评估量表（MDAS）对所有诊断为谵妄的患者进行了系统评估，在最初诊断谵妄时（T1）、48-72 h后（T2）和7天后（T3），使用Karnofsky行为量表（KPS）和简化的Udvalg Kliniske Undersogelser副作用评定量表（UKU）。所有收集的信息都输入到谵妄数据库中。对于我们的分析，我们随后提取阿立哌唑（ARI）治疗的患者的数据进行比较，以病例匹配的氟哌啶醇（HAL）治疗patients.Results：我们检索到21例阿立哌唑治疗的患者和21例病例匹配的氟哌啶醇治疗的患者。初始MDAS评分在两组之间没有显著差异。在治疗过程中（T1至T3），ARI的MDAS评分从18.1改善至8.3，HAL的MDAS评分从19.9改善至6.8。谵妄消退率ARI为76.2%，HAL为76.2%。对于低活动性谵妄患者，ARI的MDAS评分从15.6改善至5.7，HAL的MDAS评分从18.8改善至8.1。ARI组和HAL组的谵妄消退率分别为100%和77.8%。对于经历过动性谵妄的患者，ARI的MDAS评分从19.9改善至6.8，HAL的MDAS评分从20.8改善至5.8。多动性谵妄患者的谵妄消退率ARI为58.3%，HAL为75%。ARI和HAL的治疗结果无显著差异。HAL治疗引起更多的锥体外系副作用。结论：从我们的二次分析，阿立哌唑可能是有效的氟哌啶醇在谵妄及其亚型的管理。氟哌啶醇治疗导致更多的副作用。
Objective: To compare the efficacy and tolerability of aripiprazole and haloperidol in the amelioration of distressing symptoms of delirium and its motoric subtypes.Methods: At Memorial Sloan-Kettering Cancer Center, we prospectively collected sociodemographic and medical data and systematically rated all patients diagnosed with delirium with the Memorial Delirium Assessment Scale (MDAS), Karnofsky Performance Scale (KPS) and the abbreviated Udvalg Kliniske Undersogelser Side Effect Rating Scale (UKU) at the initial diagnosis of delirium (T1), after 48-72 h (T2) and 7 days later (T3). All collected information was entered into a delirium database. For our analysis, we subsequently extracted data on aripiprazole (ARI) treated patients to compare to case-matched haloperidol (HAL) treated patients.Results: We retrieved 21 patients treated with aripiprazole and 21 case-matched patients treated with haloperidol. Initial MDAS scores did not significantly differ between the groups. Over the course of treatment (T1 to T3), MDAS scores improved from 18.1 to 8.3 for ARI and 19.9 to 6.8 for HAL. The delirium resolution rate was 76.2% for ARI and 76.2% for HAL. For patients with hypoactive delirium, the MDAS scores improved from 15.6 to 5.7 for ARI and 18.8 to 8.1 for HAL. Delirium resolution rates for patients with hypoactive delirium were 100% for ARI and 77.8% for HAL. For patients experiencing hyperactive delirium, the MDAS scores improved from 19.9 to 6.8 for ARI and 20.8 to 5.8 for HAL. Delirium resolution rates for patients with hyperactive delirium were 58.3% for ARI and 75% for HAL. There were no significant differences in treatment results between ARI and HAL. Treatment with HAL caused more extrapyramidal side effects.Conclusion: From our secondary analysis, aripiprazole may be as effective as haloperidol in the management of delirium and its subtypes. Treatment with haloperidol resulted in more side effects.