Novel Therapeutic Strategies for Delirium in Patients With Cancer: A Preliminary Study

Am J Hosp Palliat Care. 2016 Jun;33(5):456-62. doi: 10.1177/1049909114565019. Epub 2014 Dec 30.

Abstract

To compare the efficacy of antipsychotics (APs) for delirium treatment in patients with cancer, 27 patients treated with 1 of the 4 APs, haloperidol (HPD), risperidone (RIS), olanzapine (OLZ), and quetiapine (QTP), were divided into 2 groups: long half-life (T1/2; HPD, RIS, and OLZ) versus short T1/2 (QTP) or the multiacting receptor-targeted APs (MARTAs; OLZ and QTP) versus the non-MARTA (HPD and RIS). The symptom severity was evaluated by the memorial delirium rating scale (MDAS) on days 0, 3, and 7 following intervention. Significant improvements in total MDAS scores were found in all groups on day 3. However, on day 7, only the short T1/2 group and MARTA group showed significant improvement. Consideration of an AP's pharmacological properties may be helpful for improving the outcomes of pharmacological delirium intervention in patients with cancer.

Keywords: MARTA; MDAS; T half; antipsychotics; delirium; patients with cancer.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / pharmacokinetics*
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / pharmacokinetics
  • Benzodiazepines / therapeutic use
  • Cross-Sectional Studies
  • Delirium / drug therapy*
  • Delirium / etiology*
  • Female
  • Half-Life
  • Haloperidol / pharmacokinetics
  • Haloperidol / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Olanzapine
  • Quetiapine Fumarate / pharmacokinetics
  • Quetiapine Fumarate / therapeutic use
  • Risperidone / pharmacokinetics
  • Risperidone / therapeutic use
  • Severity of Illness Index

Substances

  • Antipsychotic Agents
  • Benzodiazepines
  • Quetiapine Fumarate
  • Haloperidol
  • Risperidone
  • Olanzapine