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Olanzapine vs haloperidol: treating delirium in a critical care setting

Abstract

Objective

To compare the safety and estimate the response profile of olanzapine, a second-generation antipsychotic, to haloperidol in the treatment of delirium in the critical care setting.

Design

Prospective randomized trial

Setting

Tertiary care university affiliated critical care unit.

Patients

All admissions to a medical and surgical intensive care unit with a diagnosis of delirium.

Interventions

Patients were randomized to receive either enteral olanzapine or haloperidol.

Measurements

Patient’s delirium severity and benzodiazepine use were monitored over 5 days after the diagnosis of delirium.

Main results

Delirium Index decreased over time in both groups, as did the administered dose of benzodiazepines. Clinical improvement was similar in both treatment arms. No side effects were noted in the olanzapine group, whereas the use of haloperidol was associated with extrapyramidal side effects.

Conclusions

Olanzapine is a safe alternative to haloperidol in delirious critical care patients, and may be of particular interest in patients in whom haloperidol is contraindicated.

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Acknowledgement

Support for this study was generously provided by a (peer-reviewed) grant from the Zyprexa fund, Eli-Lilly, North America.

Author information

Correspondence to Yoanna K. Skrobik.

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Skrobik, Y.K., Bergeron, N., Dumont, M. et al. Olanzapine vs haloperidol: treating delirium in a critical care setting. Intensive Care Med 30, 444–449 (2004). https://doi.org/10.1007/s00134-003-2117-0

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Keywords

  • Delirium
  • Therapy
  • Critical care
  • Olanzapine
  • Haloperidol
  • Parkinson’s disease