title: Subtypes of pediatric delirium: a treatment algorithm.
abstract: Delirium in adult populations of hospitalized patients has been well characterized into hyperactive, hypoactive, and mixed subtypes. The degree to which these subtypes apply to pediatric populations has yet to be fully demonstrated. In this case report, the authors present two cases of delirium that serve as examples of the hyperactive and hypoactive/mixed types and then discuss treatment. They find marked differences in the response of different delirium subtypes to haloperidol and risperidone and theorize as to the neurochemical pathways by which these pharmacological agents might work. This framework provides an algorithm for the treatment of pediatric delirium.
authors.affiliation: Division of Child and Adolescent Psychiatry, Stanford Univ. School of Medicine, Lucile Salter Pasckard Children's Hospital, Palo Alto, CA 94305, USA. nkarnik@stanford.edu
authors.forename: Niranjan S
authors.initials: NS
authors.lastname: Karnik
authors.forename: Shashank V
authors.initials: SV
authors.lastname: Joshi
authors.forename: Caroline
authors.initials: C
authors.lastname: Paterno
authors.forename: Richard
authors.initials: R
authors.lastname: Shaw
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage; D003693:Delirium / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D004305:Dose-Response Relationship, Drug; D020803:Encephalitis, Herpes Simplex / Q000150:complications; D005260:Female; D006220:Haloperidol / Q000008:administration & dosage; D006801:Humans; D006948:Hyperkinesis / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy; D000297:Psychology, Adolescent / Q000379:methods; D011605:Psychoses, Substance-Induced / Q000150:complications; D018967:Risperidone / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D006220:Haloperidol; D018967:Risperidone