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KMID : 0605720060120020162
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Journal of the Korean Society of Biological Therapies in Psychiatry
2006 Volume.12 No. 2 p.162 ~ p.171
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Comparative Study of Haloperidol and Quetiapine in the Treatment of Delirium：A Prospective, Open Clinical Trial
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Lee Jin-Young
Kim Sang-Heon
Seo Eu-Gene
Lee Joon-Young
Shim Jae-Yong
Lee Yang-Hyun
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Abstract
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Objectives：Delirium is a complex psychiatric syndrome with an acute onset and a fluctuating course. Typical antipsychotics, especially haloperidol, have been used as the main tool for pharmacological treatment of delirium. Recently, the newly developed atypical antipsychotics have been used successfully in control of delirium. The purpose of this prospective, open-clinical trial is to compare the clinical efficacy and tolerability of haloperidol and quetiapine for the treatment of delirium.
Methods：Between July 2005 and June 2006, 36 patients who were diagnosed as having delirium according to the criteria of the DSM-IV were enrolled in this study from psychiatric practice settings and from consultation department. They were randomly assigned to be treated with a flexible-dose regimen of haloperidol(n=19) or quetiapine (n=17). K-DRS, K-DRS-R-98, CGI, MMSE-K, and ESRS had been assessed repeatedly until the K-DRS score reached 12 or less. We assumed that the patient whose K-DRS score had reached 12 or less was recovered from delirium.
Results：Sixteen subjects in haloperidol group and sixteen subjects in quetiapine group completed the study. The mean dosage of antipsychotics for delirium is 2.9mg(SD=1.8) of haloperidol and 39.8mg(SD=28.9) of quetiapine. K-DRS and K-DRS-R-98 scores in both groups were significantly decreased after individual treatments. But there were no significant differences of changing extent of CGI-Improvement, MMSE-K, K-DRS and K-DRSR- 98 scores between the groups. There was no significant difference in duration of treatment and clinical improvement between the groups. Most of the patients were well tolerated to the adverse events of each antipsychotic drug but only one patient who had been treated with haloperidol showed extrapyramidal symptom after the medication.
Conclusion：Quetiapine may be more useful than haloperidol in old aged patients with delirium because of its safety and low dose effectiveness. This trial is a prospective, open-label, flexible dose study with a small
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KEYWORD
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Delirium, Haloperidol, Quetiapine, K-DRS
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