Adding rivastigmine to antipsychotics in the treatment of a chronic delirium

Dautzenberg, Paul L. J.; Mulder, Leonie J.; Rikkert, Marcel G M Olde; Wouters, Cees J.; Loonen, Anton J. M.

doi:10.1093/ageing/afh125

Cited by 13 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dautzenberg et al [73] retrospective study mean duration of delirium before starting rivastigmine treatment was 28 days rivastigmine (added to antipsychotic) dose 3 mg / day to 9 mg / day at the time of response. of the 21 subjects, 15 (71.4 % ) recovered from their delirium after starting rivastigmine, with an average of 12.6 days (8.4 -33.6); non-response to rivastigmine implied bad prognosis and occurred preferentially in patients with neurological diseases.…”

Section: Conclusion ▼mentioning

confidence: 99%

Usefulness of Atypical Antipsychotics and Choline Esterase Inhibitors in Delirium: A Review

Grover¹,

Mattoo²,

Gupta³

2011

Pharmacopsychiatry

View full text Add to dashboard Cite

Delirium is characterized by disturbances of consciousness, attention, cognition, perception, emotions, sleep, and psychomotor activity. Management of delirium involves ensuring safety, improving functioning, identifying and treating the illness underlying the delirium, and use of antipsychotics or benzodiazepines to control behavioural symptoms and prevent mortality. Haloperidol continues to be the most commonly used antipsychotic in delirium. However, in recent times data have emerged which suggest that atypical antipsychotics may be as efficacious as haloperidol in the treatment of delirium. This review intends to review the data with respect to usefulness of atypical antipsychotics in the treatment of delirium. Besides atypical antipsychotics, data with respect to another group of medications - cholinesterase inhibitors are also reviewed. Electronic and manual searches were conducted to identify all the relevant studies and case reports/case series. Evidence suggests that risperidone, olanzapine and quetiapine are as efficacious as haloperidol in the treatment of delirium but have lesser side effects. Data for other atypical antipsychotics are scarce. The data on cholinesterase inhibitors for treatment and prevention of delirium are beginning to accumulate, but do not seem to be convincing. Our review suggests that risperidone, olanzapine and quetiapine are good alternatives to haloperidol in the treatment of delirium.

show abstract

Section: Conclusion ▼mentioning

confidence: 99%

Usefulness of Atypical Antipsychotics and Choline Esterase Inhibitors in Delirium: A Review

Grover¹,

Mattoo²,

Gupta³

2011

Pharmacopsychiatry

View full text Add to dashboard Cite

show abstract

“…Dans une méta-analyse récente, une recherche bibliographique menée sur le thème de la confusion de l'adulte, et non pas exclusivement du sujet âgé, n'a pas mis en évidence de démonstration significative de l'efficacité des benzodiazépines dans la prise en charge de la confusion de l'adulte. Ponctuellement, principalement dans des études ouvertes, l'efficacité de certains médicaments tels que les statines (dont la consommation préopératoire réduirait l'incidence de la confusion au décours d'une chirurgie [28], de l'association rivastigmine-antipsychotiques dans le traitement de la confusion chronique [29] de la miansérine (efficacité sur les troubles du sommeil et du comportement) [30], des inhibiteurs de l'acétylcho-linestérase dans le traitement des confusions iatrogènes secondaires à la consommation d'opioïdes [31], ont été proposées avec des efficacités variables.…”

Section: Confusion : Traitementunclassified

Conduite à tenir devant un syndrome confusionnel chez un sujet âgé

Chassagne

Guillou

Gbaguidi

et al. 2009

cah. année gerontol.

View full text Add to dashboard Cite

La confusion est un symptôme fréquent qui a un pronostic sévère, en particulier si sa prise en charge est retardée. La confusion expose à des hospitalisations prolongées, à une perte fonctionnelle et, enfin, est associée à une surmortalité. Les principaux facteurs de risque de confusion sont l'âge et l'existence d'un syndrome démen-tiel. Elle peut se dépister en utilisant des échelles validées telles que la CAM, et des critères précis pour retenir ce diagnostic doivent être réunis. On oppose les confusions par l'intensité de leurs manifestations psychomotrices (confusions hypoactives ou hyperactives) et par leurs durées brèves ou prolongées. Les confusions prolongées posent le problème du diagnostic différentiel avec un syndrome démentiel. Le traitement d'une confusion est avant tout préventif en ciblant les populations à risque et les circonstances cliniques où elles sont fréquentes comme la période postopératoire après une fracture du col fémoral.Abstract Confusion is a common condition associated with a poor outcome, especially when diagnosis is delayed. Confusion is associated with disability, prolonged hospital stays and a high mortality rate. The main risk factors of confusion are age and dementia. Confusion can be detected using a reproducible tool such as the CAM, and specific criteria (DSM-IV) must be present to confirm the diagnosis. Various confusion patterns exist and are classified according to intensity of psychomotor activities (hypo-or hyperactive) or duration of the disorder. Long-lasting confusion can be difficult to distinguish from dementia. Treatment for confusion should be preventive, focusing on high-risk groups of patients, especially in the postoperative period for elderly inpatients treated for femoral neck fracture.

show abstract

“…However, no randomized controlled trials of cholinesterase inhibitors for the treatment of delirium in acute medical, critical care, or postoperative populations have been published. Similarly, the potential role of combination therapy of a cholinesterase inhibitor and antipsychotic have not been prospectively studied [72].…”

Section: Cholinesterase Inhibitorsmentioning

confidence: 99%