Antipsychotics Don’t Help ICU Delirium

There are conflicting data on the effects of antipsychotic medications on delirium in patients in the intensive care unit (ICU).  A randomized, double-blinded controlled study, published last month in the New England Journal of Medicine, aimed to measure days alive without delirium or coma in patients with delirium managed by placebo, haloperidol or ziprasidone. Of the 566 patients, 184 were assigned to receive placebo, 192 to receive haloperidol, and 190 to receive ziprasidone. Eighty-nine percent of patients had hypoactive delirium. Investigators concluded that the use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.

Link to: N Eng J Med (10/2018) Pallimed (10/2018)