First- and second-line pharmacological treatment for delirium in general hospital setting-Retrospective analysis

Asian J Psychiatr. 2018 Feb:32:50-53. doi: 10.1016/j.ajp.2017.11.028. Epub 2017 Dec 5.

Abstract

Aim: We examined the first- and second-line pharmacological treatment for delirium to determine which drugs were chosen, how and when second-line drugs were started, and the effectiveness and tolerability of those treatments.

Methods: A retrospective medical chart review was performed for delirium inpatients referred to the Department of Psychiatry, Hiroshima Citizens Hospital, from October 2011 to September 2012. Clinical diagnoses were based on ICD-10. We compared the baseline severity of delirium, duration needed for improvement, and rescue with antipsychotics between subjects given only first-line drugs and those switched to second-line drugs.

Results: We studied 194 consecutive patients including 127 men and 67 women whose average age was 76.5±9.8years. For first-line drugs, trazodone was most frequently prescribed (n=100, 51.5%), followed by quetiapine (n=57, 29.4%). Among patients treated with trazodone or quetiapine as first line treatment, 59 of 100 (59%) continued trazodone and 52 of 57 (91.2%) continued quetiapine. Duration needed for improvement did not differ significantly between patients treated with trazodone as a first line drug and those with quetiapine as same.

Conclusion: Trazodone can be a candidate drug as one of the first line drugs for delirium.

Keywords: Consultation liaison service; Delirium; Pharmacological treatment; Quetiapine; Trazodone.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use*
  • Delirium / drug therapy*
  • Female
  • Hospitals, General / statistics & numerical data*
  • Humans
  • Japan
  • Male
  • Quetiapine Fumarate / therapeutic use*
  • Retrospective Studies
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Trazodone / therapeutic use*

Substances

  • Antipsychotic Agents
  • Quetiapine Fumarate
  • Selective Serotonin Reuptake Inhibitors
  • Trazodone