Delirium medical therapy
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Delirium Microchapters |
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Diagnosis |
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Treatment |
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Delirium On the Web |
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American Roentgen Ray Society Images of Delirium |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishal Khurana, M.B.B.S., M.D. [2]; Pratik Bahekar, MBBS [3]
Overview
Treatment of Delirium
Delirium is not a disease, but a syndrome (i.e. collection of symptoms) indicating dysfunction of the brain, in the same way shortness of breath describes dysfunction of the respiratory system, but does not identify the disorder. Treatment of delirium is achieved by treating the underlying dysfunction cause, or in many cases, the causes (plural), as delirium is often multi-factorial.
Antipsychotics are the treatment of choice for distressing symptoms although ones with minimal anticholinergic activity, such as haloperidol or risperidone are preferable. Benzodiazepines are usually used in alcohol withdrawal.
- Treatment of underlying etiology important, as delirium can be reversible if diagnosed and treated correctly
- Surrounding environment supports to help with orientation
- Psychosocial support
- Safety of environment
Pharmacotherapy
Acute Pharmacotherapies
Haloperidol a typical antipsychotic drug is a preferred drug in delirium, because of its lower anticholinergic properties. Typically doses of haloperidol differ for different subset of patients.0.25 to 0.50mg four hourly for the geriatric population, seriously ill patients, 2 to 3mg per day in healthier patients. However for very agitated patients, 5 to 10mg per hour iv dose has been used in the inpatient settings. Lowest possible antipsychotic doses should be given. For more sever agitation antipsychotics are supplemented with benzodiazepines and ventilator support.
Combination of haloperidol and chlorpromazine has also been tried in few studies with positive outcomes. .[1]