An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients

Psychosomatics. 2002 May-Jun;43(3):175-82. doi: 10.1176/appi.psy.43.3.175.

Abstract

We conducted an open, prospective trial of olanzapine for the treatment of delirium in a sample of 79 hospitalized cancer patients. Patients all met DSM-IV criteria for a diagnosis of delirium and were rated systematically with the Memorial Delirium Assessment Scale (MDAS) as a measure of delirium severity, phenomenology, and resolution, over the course of a 7-day treatment period. Sociodemographic and medical variables and measures of physical performance status and drug-related side effects were collected. Fifty-seven patients (76%) had complete resolution of their delirium on olanzapine therapy. No patients experienced extrapyramidal side effects; however, 30% experienced sedation (usually not severe enough to interrupt treatment). Several factors were found to be significantly associated with poorer response to olanzapine treatment for delirium, including age >70 years, history of dementia, central nervous system spread of cancer and hypoxia as delirium etiologies, "hypoactive" delirium, and delirium of "severe" intensity (i.e., MDAS >23). A logistic-regression model suggests that age >70 years is the most powerful predictor of poorer response to olanzapine treatment for delirium (odds ratio, 171.5). Olanzapine appears to be a clinically efficacious and safe drug for the treatment of the symptoms of delirium in the hospitalized medically ill.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines
  • Chi-Square Distribution
  • Delirium / drug therapy*
  • Delirium / etiology
  • Female
  • Humans
  • Inpatients / psychology
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / psychology*
  • Olanzapine
  • Pirenzepine / analogs & derivatives
  • Pirenzepine / therapeutic use*
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index

Substances

  • Antipsychotic Agents
  • Benzodiazepines
  • Pirenzepine
  • Olanzapine