Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study

Abstract

The present study aimed to: (i) provide preliminary data on the effectiveness and tolerability of atypical antipsychotics, amisulpride (AMSP) and quetiapine (QTP) for patients with delirium and (ii) investigate whether the two drugs affect sleep differently and further relation with the recovery time of delirium. Forty patients with delirium were randomly assigned to either AMSP or QTP groups, with a flexible dosing schedule. The Delirium Rating Scale-revised-98 (DRS-R-98) and clinical global impression-severity (CGI-S), total sleep time and quality of sleep were assessed daily. Sixteen subjects in the AMSP group and 15 subjects in the QTP group completed the study. The mean daily dose was 156.4 mg/day and 113 mg/day in the AMSP and QTP groups, respectively. There was no significant difference in the baseline DRS-R-98 and CGI scores. After treatment, DRS-R-98 scores were significantly decreased from the baseline in both treatment groups (P<0.001) without group difference. The mean duration of stabilization were 6.3+/-4.4 days for the AMSP group and 7.4+/-4.1 days for the QTP group without group differences. There was no group difference in the mean quality of sleep score and the mean total sleep time. The duration of stabilization was inversely correlated with the mean sleep quality score and the mean total sleep time (P<0.001). Both atypical antipsychotics were generally well tolerated. The present study shows that both amisulpride and quetiapine may be useful drugs for the treatment of delirium on the basis of effectiveness and relative lack of adverse events. Further systematic controlled studies are required.

Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients

“…Skrobik et al [89] demonstrated that olanzapine was a safe alternative to haloperidol for delirious patients in the ICU with similar clinical improvement and less EPS. Similar results have been demonstrated in smaller, non-placebo-controlled studies with amisulpride [90], quetiapine [90,91], and risperidone [92,93]. Recently, a prospective, single-blind, randomized controlled trial compared the efficacy and safety of haloperidol, olanzapine, and risperidone in the treatment of delirium with 20 to 23 patients in each arm of the study [94].…”

QUADERNI - Italian Journal of Medicine 2013

“…Le linee guida NICE 20 identificano come significativi tre studi (Hu, 2006;Lee, 2005;. Lo studio di Hu 21 e quello di Lee 22 focalizzavano l'attenzione sul trattamento del delirium nei pazienti ospedalizzati, eslcudendo quelli ricoverati in terapia intensiva.…”

Evaluación de la evidencia existente sobre la efectividad de la quetiapina para el tratamiento del delirium: Análisis sistemático de Medicina Basada en la Evidencia

“…Estudios encontrados que han evaluado la efectividad de la quetiapina como tratamiento del delirium. [37][38][39][40][41][42][43] • Seis eran estudios específicos que abordaban la efectividad de la quetiapina como tratamiento del delirium [7,[44][45][46][47][48] …”

“…Lee et al [47] realizaron un estudio abierto, randomizado, con dosis flexibles de quetiapina y amisulpride, que pretendía comparar la eficacia (medida con la DRS-R-98) y tolerabilidad de ambos fármacos y de forma secundaria valorar su repercusión sobre medidas subjetivas de sueño. De los 40 individuos que iniciaron el estudio, 31 lo finalizaron (77.5%) (15 en grupo de quetiapina y 16 en el de amisulpride), los cuales no mostraron diferencias en parámetros sociodemográficos.…”