Reconsidering Current Strategies for Delirium.

• Position: ANTIPSYCHOTICS

Critically ill patients in intensive care units do not benefit from two antipsychotic drugs (haloperidol and ziprasidone) used to treat delirium, according to a clinical trial conducted by researchers led by E. Wesley Ely, professor of medicine at Vanderbilt University Medical Center, Nashville, Tenn.; associate director of Research for the VA Geriatric Research Education Clinical Center; and codirector of the CIBS (Critical Illness, Brain dysfunction, and Survivorship) Center.

Delirium is an acute disturbance in attention and awareness with symptoms that can include disorganized thinking and agitation. More than 7,000,000 hospitalized Americans per year experience delirium. It can affect patients of any age, but is more common among older adults who experience major illness--especially involving an ICU stay--or have major surgery.

Delirium also is associated with higher ICU costs and multiple adverse outcomes, such as longer hospital stays, long-term cognitive impairment, and death.

Antipsychotic medications have been used to treat delirium in ICU patients for 40 years without definitive understanding of their effectiveness.

Researchers found no significant difference in duration of delirium or coma among those participants on haloperidol or ziprasidone...