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

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 ۳۵ 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 ۰ and ۳ of ICUadmission.Results: The total sample size was ۳۵ in which ۱۶ patients received haloperidol, and ۱۹patients received olanzapine. The doses of haloperidol and olanzapine were ۳ mg threetimes a day and ۵ 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

Keywords:

delirium , Haloperidol , Olanzapine , Toxicology , Intensive Care Unit