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Commonly Used Drug Does Not Reduce Delirium in Critically Ill Patients

Haloperidol no more effective than placebo, study shows (August 21)

Delirium, or severe confusion and disorientation, is often experienced by critically ill patients, and critically ill patients who develop delirium are up to three times more likely to die by 6 months than are those without delirium. Delirium may also add to the distress and discomfort experienced by both a critically ill patient and his or her family.

In a study published in The Lancet, researchers in the U.K. tested the effect of intravenous haloperidol on delirium in 141 critically ill patients on artificial ventilation. Seventy-one patients received haloperidol to treat delirium, and the remaining 70 patients received placebo.

Haloperidol doses were based on existing clinical practice for the management of delirium, and patients were carefully monitored for adverse reactions to the drug, as well as for over-sedation.

The researchers found that patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median, 5 days vs. 6 days, respectively; P = 0.53).

However, despite its lack of effectiveness in treating delirium, the trial showed that patients given haloperidol seemed to require less sedation than those given placebo, suggesting that the drug may still be useful for short-term management of acute agitation.

Source: Lancet; August 21, 2013.

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