Comparative effectiveness of quetiapine and haloperidol in delirium: A single blind randomized controlled study.
OBJECTIVE
To evaluate the effectiveness of quetiapine and haloperidol in patients of delirium referred to psychiatry consultation liaison services.


METHODS
The study followed a single blind randomised controlled trial design. Thirty-two patients in the haloperidol group and 31 patients in the quetiapine group were assessed at the baseline and 6 consecutive days. Flexible dosing regimen (haloperidol: 0.25-1.25 mg; quetiapine 12.5-75 mg/d) was used. Delirium Rating Scale-Revised-98 (DRS-R-98) and mini mental status examination (MMSE) were the primary and secondary efficacy measures respectively.


RESULTS
Baseline DRS-R-98 severity score and MMSE scores did not differ between the 2 study groups. From baseline to day 6, there was significant reduction in the total DRS-R-98 scores, DRS-R-98 cognitive domain scores, DRS-R-98 non-cognitive domain scores and significant increase in the MMSE scores in both the groups. Both the groups did not differ on any of the assessments in terms of DRS-R98 and MMSE scores. The effectiveness of both the medications was similar in adult and elderly (≥ 60 years) patients. At the end of the trial, 68.75% and 67.74% of subjects in the haloperidol and quetiapine group respectively had mean DRS-R-98 scores below 10. By 6(th) day, 12 (37.5%) patients in haloperidol group and 9 (29.03%) patients in the quetiapine group had DRS-R98 score of "0" with no significant difference between the two groups (P = 0.47).


CONCLUSIONS
Quetiapine is as effective as haloperidol in the management of delirium.
Sandeep Grover, Sudhir Mahajan, Subho Chakrabarti, Ajit Avasthi, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Sandeep
S
Grover
Sandeep Grover, Sudhir Mahajan, Subho Chakrabarti, Ajit Avasthi, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Sudhir
S
Mahajan
Sandeep Grover, Sudhir Mahajan, Subho Chakrabarti, Ajit Avasthi, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Subho
S
Chakrabarti
Sandeep Grover, Sudhir Mahajan, Subho Chakrabarti, Ajit Avasthi, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
Ajit
A
Avasthi
Atypical antipsychotics; Delirium; Effectiveness; Quetiapine
J Psychosom Res. 2010 Nov;69(5):485-90
20955868
J Psychosom Res. 2011 May;70(5):473-8
21511078
Pharmacopsychiatry. 2011 Mar;44(2):43-54
21394715
Crit Care Med. 2010 Feb;38(2):419-27
19915454
Int Clin Psychopharmacol. 2005 Nov;20(6):311-4
16192839
J Geriatr Psychiatry Neurol. 2003 Mar;16(1):29-31
12641370
Psychiatry Res. 2013 Mar 30;206(1):68-74
23021910
J Neuropsychiatry Clin Neurosci. 2001 Spring;13(2):229-42
11449030
Psychosomatics. 2003 Jul-Aug;44(4):350-1
12832605
Gen Hosp Psychiatry. 2009 Jan-Feb;31(1):25-9
19134506
Psychol Med. 1994 Feb;24(1):145-53
8208879
J Psychiatr Res. 1975 Nov;12(3):189-98
1202204
J Neuropsychiatry Clin Neurosci. 2008 Spring;20(2):185-93
18451189
J Clin Psychiatry. 2003 Nov;64(11):1316-21
14658945
Psychosomatics. 2005 Jul-Aug;46(4):374-5
16000684
Psychosomatics. 2001 Jul-Aug;42(4):347-9
11496025
Prim Care Companion J Clin Psychiatry. 2000 Feb;2(1):10-12
15014661
Hum Psychopharmacol. 2004 Mar;19(2):125-7
14994323
Crit Care. 2011;15(5):R215
21923923
Cleve Clin J Med. 2011 Apr;78(4):243-57
21460130
J Clin Psychopharmacol. 2007 Oct;27(5):526-8
17873696
J Med Assoc Thai. 2007 Oct;90(10):2158-63
18041437
J Psychosom Res. 2011 Oct;71(4):277-81
21911107