Abstract
Delirium is characterized by disturbances of consciousness, attention, cognition,
perception, emotions, sleep, and psychomotor activity. Management of delirium involves
ensuring safety, improving functioning, identifying and treating the illness underlying
the delirium, and use of antipsychotics or benzodiazepines to control behavioural
symptoms and prevent mortality. Haloperidol continues to be the most commonly used
antipsychotic in delirium. However, in recent times data have emerged which suggest
that atypical antipsychotics may be as efficacious as haloperidol in the treatment
of delirium. This review intends to review the data with respect to usefulness of
atypical antipsychotics in the treatment of delirium. Besides atypical antipsychotics,
data with respect to another group of medications – cholinesterase inhibitors are
also reviewed. Electronic and manual searches were conducted to identify all the relevant
studies and case reports/case series. Evidence suggests that risperidone, olanzapine
and quetiapine are as efficacious as haloperidol in the treatment of delirium but
have lesser side effects. Data for other atypical antipsychotics are scarce. The data
on cholinesterase inhibitors for treatment and prevention of delirium are beginning
to accumulate, but do not seem to be convincing. Our review suggests that risperidone,
olanzapine and quetiapine are good alternatives to haloperidol in the treatment of
delirium.
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Correspondence
Dr. S. Grover
Department of Psychiatry
Postgraduate Institute of
Medical Education & Research
160012 Chandigarh
India
Telefon: +91/172/275 6807
Fax: +91/172/274 4401
Fax: +91/172/274 5078
eMail: drsandeepg2002@yahoo.com
