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World J Psychiatry. 2016 Sep 22;6(3):365-71. doi: 10.5498/wjp.v6.i3.365. eCollection 2016 Sep 22.

Comparative effectiveness of quetiapine and haloperidol in delirium: A single blind randomized controlled study.

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1
Sandeep Grover, Sudhir Mahajan, Subho Chakrabarti, Ajit Avasthi, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.

Abstract

AIM:

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).

CONCLUSION:

Quetiapine is as effective as haloperidol in the management of delirium.

KEYWORDS:

Atypical antipsychotics; Delirium; Effectiveness; Quetiapine

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