Tag: antipsychotics

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A new study finding that two antipsychotics were no more effective than placebo for delirium in critical illness spurs discussion about alternative methods for managing that care. Neither haloperidol nor ziprasidone — both antipsychotics — significantly alters the duration of delirium in critical illness, according to a new clinical trial published online October 22 in the New England Journal of Medicine. The trial randomized 566... Read More | Comment
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Delirium is defined as an acute disorder of consciousness which can occur in up to 80% of mechanically ventilated ICU patients. This acute cognitive dysfunction is associated with prolonged hospital stay, increased mortality, longer periods of mechanical ventilation and long-term cognitive impairment compared to patients without delirium. Haloperidol, remains one of the most commonly used typical antipsychotics used to treat delirium internationally and within the... Read More | Comment
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Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles. Overall, antipsychotics don’t reverse the underlying pathophysiologic causes of delirium. However, antipsychotics can be useful to alleviate symptoms of agitation and insomnia, allowing the patient to be managed safely while delirium... Read More | Comment
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In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly increased the odds of discharge with an antipsychotic prescription, a practice that should be examined carefully during medication reconciliation since these drugs carry “black box warnings” regarding long-term use. After excluding 18 patients due... Read More | Comment