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KMID : 0605720070130020180
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Journal of the Korean Society of Biological Therapies in Psychiatry
2007 Volume.13 No. 2 p.180 ~ p.189
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Randomized, Open Trial of Aripiprazole Versus Haloperidol in the Treatment of Delirium
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Lee Joonyoung
Chung Un-Sun
Jo Hyun-Young
Lee Byung-Dae
Lee Yang-Hyun
Jeong Sung-Hoon
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Abstract
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Objectives: Delirium is a common condition frequently seen in consultation-liaison psychiatry. Antipsychotic drugs are the primary treatment for symptoms of delirium. Typical antipsychotics, especially haloperidol, have been used as the mainstay of pharmacological treatment of delirium. With the introduction of atypical antipsychotics, the clinical usefulness of these medication has also been investigated for delirious patients. The purpose of this randomized, open-clinical trial is to compare the clinical efficacy and tolerability of haloperidol and aripiprazole for the treatment of delirium.
Methods: 45 patients with a diagnosis of delirium were enrolled between July 2005 and May 2007 in this study. They were randomly assigned to be treated with a flexible-dose regimen of haloperidol or aripiprazole. The Korean version of Delirium Rating Scale(K-DRS) and other measures related with delirium had been used repeatedly until the K-DRS score reached 12 or less which we defined as the criteria for recovery from delirium. 22 subjects in haloperidol group and 19 in aripiprazole group completed the study.
Results: The mean dosage of antipsychotics for delirium was 3.0±1.6㎎ of haloperidol and 5.5±1.5㎎ of aripiprazole which was relevant to 150.5±83.6㎎ and 73.7±20.9㎎ of chlorpromazine respectively. Aripiprazole was effective to subside the delirium symptoms at less dosages than haloperidol. There were no significant group differences in the score of K-DRS, K-DRS-R-98 and MMSE-K at baseline as well as final assessments. 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 two patients in haloperidol group showed extrapyramidal symptom.
Conclusion: Aripiprazole may be more useful than haloperidol in patients with delirium because of its safety and low dose effectiveness, especially in aged patients. Further double-blind placebo-controlled studies with a large sample size will be necessary.
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KEYWORD
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Delirium, Aripiprazole, Haloperidol, K-DRS, K-DRS-R-98, Aripiprazole, Haloperidol
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