Ziprasidone for the Treatment of Delirium: Case Studies
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Delirium is common in hospitalized patients, and the gold standard for the control of its symptoms is haloperidol. Haloperidol,however, has some adverse effects, including extrapyramidal symptoms, which require limiting its use. Many studies have reported on the effectiveness of atypical antipsychotics such as aripiprazole, risperidone, olanzapine, and quetiapine for delirium,all of which have been found to be safe and effective alternatives to haloperidol. To our knowledge, only two reports have described the use of ziprasidone for treating delirium; such reports may be rare for several reasons, but the most likely one concerns its adverse effects. Although ziprasidone has the potential to cause dose-related QTc interval prolongation and is considered more likely to do so than several other antipsychotics, clinically significant prolongation of the QTc interval (generally defined as ＞500 ms) with recommended dosages of ziprasidone has been uncommon. Generally, checking the electrocardiogram regularly in patients without heart disease who take ziprasidone is thought to be unnecessary. We herein describe some patients with delirium who were treated with ziprasidone. A low rate of adverse effects was observed, and thus ziprasidone may be an appropriate for the treatment of delirium. A controlled comparison study should be performed to confirm this finding.
Abstract
Delirium is common in hospitalized patients, and the gold standard for the control of its symptoms is haloperidol. Haloperidol,however, has some adverse effects, including extrapyramidal symptoms, which require limiting its use. Many studies have reported on the effectiveness of atypical antipsychotics such as aripiprazole, risperidone, olanzapine, and quetiapine for delirium,all of which have been found to be safe and effective alternatives to haloperidol. To our knowledge, only two reports have described the use of ziprasidone for treating delirium; such reports may be rare for several reasons, but the most likely one concerns its adverse effects. Although ziprasidone has the potential to cause dose-related QTc interval prolongation and is considered more likely to do so than several other antipsychotics, clinically significant prolongation of the QTc interval (generally defined as ＞500 ms) with recommended dosages of ziprasidone has been uncommon. Generally, checking the electrocardiogram regularly in patients without heart disease who take ziprasidone is thought to be unnecessary. We herein describe some patients with delirium who were treated with ziprasidone. A low rate of adverse effects was observed, and thus ziprasidone may be an appropriate for the treatment of delirium. A controlled comparison study should be performed to confirm this finding.
참고문헌 (22)
- Farmer S, "Incidence of delirium in a geriatric ward of a university hospital", Ugeskr Laeger, 168, pp.2906~2910 (2006)
- Villalpando-Berumen JM, "Incidence of delirium, risk factors, and long-term survival of elderly patients hospitalized in a medical specialty teaching hospital in Mexico City", Int Psychogeriatr, 15, pp.325~336 (2003)
- Levkoff S, "Epidemiology of delirium: an overview of research issues and findings", Int Psychogeriatr, 3, pp.149~167 (1991)
- Shapiro BA, "Practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit: an executive summary. Society of Critical Care Medicine", Crit Care Med, 23, pp.1596~1600 (1995)
- Gö tz AK, "Severe anticholinergic drug-induced delirium in a young adult after renal transplantation", Transpl Int, 22, pp.249~250 (2009)
- Alao AO, "Aripiprazole and delirium", Ann Clin Psychiatry, 18, pp.267~269 (2006)
- Horikawa N, "Treatment for delirium with risperidone: results of a prospective open trial with 10 patients", Gen Hosp Psychiatry, 25, pp.289~292 (2003)
- Lee KU, "Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study", Int Clin Psychopharmacol, 20, pp.311~314 (2005)
- Rea RS, "Atypical antipsychotics versus haloperidol for treatment of delirium in acutely ill patients", Pharmacotherapy, 27, pp.588~594 (2007)
- Skrobik YK, "Olanzapine vs haloperidol: treating delirium in a critical care setting", Intensive Care Med, 30, pp.444~449 (2004)
- Sipahimalani A, "Use of risperidone in delirium: case reports", Ann Clin Psychiatry, 9, pp.105~107 (1997)
- Ravona-Springer R, "Delirium in elderly patients treated with risperidone: a report of three cases", J Clin Psychopharmacol, 18, pp.171~172 (1998)
- Mittal D, "Risperidone in the treatment of delirium: results from a prospective open-label trial", J Clin Psychiatry, 65, pp.662~667 (2004)
- Han CS, "A double-blind trial of risperidone and haloperidol for the treatment of delirium", Psychosomatics, 45, pp.297~301 (2004)
- Leso L, "Ziprasidone treatment of delirium", Psychosomatics, 43, pp.61~62 (2002)
- Young CC, "Intravenous ziprasidone for treatment of delirium in the intensive care unit", Anesthesiology, 101, pp.794~795 (2004)
- Swainston Harrison T, "Ziprasidone: a review of its use in schizophrenia and schizoaffective disorder", CNS Drugs, 20, pp.1027~1052 (2006)
- Montvale NJ, "Physicians Desk Reference. 61st ed", pp.2529~2535 (2007), Medical Economics Company
- Glassman AH, "Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death", Am J Psychiatry, 158, pp.1774~1782 (2001)
- Harrigan EP, "A randomized evaluation of the effects of six antipsychotic agents on QTc, in the absence and presence of metabolic inhibition", J Clin Psychopharmacol, 24, pp.62~69 (2004)
- Lieberman JA, "Effectiveness of antipsychotic drugs in patients with chronic schizophrenia", N Engl J Med, 353, pp.1209~1223 (2005)
- Girard TD, "Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial", Crit Care Med, 38, pp.428~437 (2010)