Comparison of Treatment Response of Antipsychotics According to Sedative Effect in the Treatment of Patients with Delirium

Lee, Seung Jik; Jeong, Jong Hyun; Kim, Tae Won; Lim, Hyun Kook; Seo, Ho Jun; Hong, Seung Chul; Han, Jin Hee

Abstract

OBJECTIVE
The purpose of the study is to compare treatment responses and side effects of antipsychotic medications in hospitalized delirium patients.
METHODS
Among delirium patients hospitalized 23 less-sedating agent group and 26 sedating agent group were included in the study. Less sedating agents are haloperidol and risperidone, and sedating agents are olanzapine and quetiapine. All candidates underwent Clinical Global Impression Scale (CGI), Delirium Rating Scale-Revised 98 (DRS-R 98), and Extrapyramidal Symptom Rating Scale during the treatment period. At baseline, 1st day, 2nd day, 3rd day, 4th day, 5th day, 6th day, 7th day, 10th day, and 14th day, we compared treatment responses and side effect profiles between two groups.
RESULTS
The remission defined as below 16 score of DRS-R 98, and the remission rate of both group were 78.3% at less-sedating agent group, and 80.8% at sedating agent group. They showed no difference each other. Time to remission of less-sedating group was significantly shorter than sedating group, they were 2.89+/-1.41 days at less-sedating agent group, and 5.76+/-4.45 days at sedating agent group (p=0.015). After 2 days of treatment, less-sedating agent group showed greater decrement of CGI-S score than sedating agent group, the score were 3.22+/-1.20 at less-sedating agent, and 4.00+/-1.22 at sedating agent group (p=0.030). And DRS-R 98 score after 2 days of treatment showed difference between both group, less-sedating agent group was 17.00+/-8.88, and sedating group was 22.72+/-8.49, they were different statistically (p=0.044). The mean dosage of each drugs were haloperidol 1.93 mg, risperidone 0.71 mg, olanzapine 3.75 mg, and quetiapine 46.09 mg. But there were no significant differences of rate of adverse effects.
CONCLUSION
There were no differences of total remission rate and rate of adverse effects between two groups for 2 weeks. But less-sedating agent group showed shorter time to remission and shorter duration of medication than sedating agent group. This study suggests that less-sedating agents are more suitable for early days of delirium treatment.