Comparison of the Clinical Efficacy and Safety between Intramuscular Olanzapine and Intramuscular Haloperidol Injection in the Treatment of Delirium

Lim, Hyun Kook; Paik, In Ho; Oh, Keun; Lee, Chang Uk; Lee, Chul

Abstract

OBJECTIVE
The present study aimed to provide preliminary data on the effectiveness and tolerability of intramuscular (IM) olanzapine and IM haloperidol for patients with delirium.
METHODS
Sixty-two patients with delirium were randomly assigned to either olanzapine IM or haloperidol IM groups, with a flexible dosing schedule for 7 days. The Delirium Rating Scale-revised-98 (DRS-R-98), clinical global impression-severity (CGI-S) were assessed daily. The Simpson-Angus Rating Scale (SAS), the Barnes Akathisia Rating Scale (BARS) and the Abnormal Involuntary Movement Scale (AIMS) were used for the assessments of side effects.
RESULTS
The DRS-R-98 scores were significantly decreased over time (F=26.02, P<0.0001), without any significant group differences (F=0.048, P=0.829), and time by treatment group interaction (F=5.64, P=0.725). There were no serious adverse events in both groups. The scores on the SAS, BARS, and AIMS were not changed significantly during the study.
CONCLUSIONS
This study showed that olanzapine IM did not show any superior efficay and safety compared with haloperidol IM in treatment delirium. However our study suggested that either olanzapine IM or haloperidol IM would be effective and tolerable. Adequately powered studies with a head-to-head comparison design will be mandatory to draw any definite conclusion.