Volume 30, Number 3, 444-449, DOI: 10.1007/s00134-003-2117-0

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Olanzapine vs haloperidol: treating delirium in a critical care setting

YoannaK. Skrobik, Nicolas Bergeron, Marc Dumont and StewartB. Gottfried

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Abstract

Objective  

To compare the safety and estimate the response profile of olanzapine, a second-generation antipsychotic, to haloperidol in the treatment of delirium in the critical care setting.

Design  

Prospective randomized trial

Setting  

Tertiary care university affiliated critical care unit.

Patients  

All admissions to a medical and surgical intensive care unit with a diagnosis of delirium.

Interventions  

Patients were randomized to receive either enteral olanzapine or haloperidol.

Measurements  

Patientrsquos delirium severity and benzodiazepine use were monitored over 5 days after the diagnosis of delirium.

Main results  

Delirium Index decreased over time in both groups, as did the administered dose of benzodiazepines. Clinical improvement was similar in both treatment arms. No side effects were noted in the olanzapine group, whereas the use of haloperidol was associated with extrapyramidal side effects.

Conclusions  

Olanzapine is a safe alternative to haloperidol in delirious critical care patients, and may be of particular interest in patients in whom haloperidol is contraindicated.

Keywords  Delirium - Therapy - Critical care - Olanzapine - Haloperidol - Parkinsonrsquos disease

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