Olanzapine vs haloperidol: treating delirium in a critical care setting.
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.


METHODS
Prospective randomized trial.


METHODS
Tertiary care university affiliated critical care unit.


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


METHODS
Patients were randomized to receive either enteral olanzapine or haloperidol.


METHODS
Patient's delirium severity and benzodiazepine use were monitored over 5 days after the diagnosis of delirium.


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.
Skrobik
Yoanna K
YK
Department of Critical Care, Maisonneuve Rosemont Hospital, Université de Montreal, 5415 boul de l'Assomption, Montreal, Quebec H1T 2M4, Canada. skrobiky@total.net
Bergeron
Nicolas
N
Dumont
Marc
M
Gottfried
Stewart B
SB
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D003693:Delirium / Q000188:drug therapy*; D006220:Haloperidol / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007263:Infusions, Parenteral; D007362:Intensive Care Units; D008875:Middle Aged; D000077152:Olanzapine; D011446:Prospective Studies
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine