Evaluating the risk profile of quetiapine in treating delirium in the intensive care adult population: A retrospective review

Mangan, Kyle; McKinzie, Brian P.; Deloney, Lindsay; Leon, Stuart; Eriksson, Evert A.

doi:10.1016/j.jcrc.2018.07.005

Cited by 8 publications

(3 citation statements)

References 11 publications

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“…It can be seen that the results of the study by Burry and his colleagues are in general contradictory to the results of our study. In a study by Mangan and colleagues aimed at evaluating the safety of quetiapine in delirium patients, they found that the drug generally had very few adverse effects (24). The results of our study also showed that none of the patients had any side effects.…”

Section: Discussionsupporting

confidence: 66%

Comparison of the Effect of Quetiapine With Haloperidol in Treatment of Delirium in Icu Patients

2020

jcr

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Introduction: Delirium is a relatively common disorder in ill patients. Haloperidol, a first-generation antipsychotic, is known to be the main treatment, but it has extrapyramidal side effects, whereas quetiapine is a second-generation antipsychotic and lacks these effects. In a recent study, we compared the effects of quetiapine with haloperidol in the treatment of delirium symptoms. Materials and methods: This study was a clinical trial performed on patients with delirium. Patients were randomly divided into two groups, one group receiving haloperidol 2.5 mg daily and the other group receiving 25 mg daily quetiapine. Sedation status of patients was determined based on RASS scoring criteria and disease severity according to APACHE II criteria and finally data were analyzed by SPSS 20 software. Results: The mean age of patients in quetiapine and haloperidol group was 59.83 with standard deviation of 16.51 and 64.90 with standard deviation of 21.34 years (p-value = 0.308). The ratio of male to female in the quetiapine and haloperidol group was 19 to 11 and 21 to 9, respectively (p-value = 0.392). Patients in quetiapine group had significantly better RASS and disease severity than patients in haloperidol group (p-value = 0.001). Conclusion: According to the results, it is concluded that the use of quetiapine can not only be effective in improving sedation status and severity of disease in patients with delirium, but also better than haloperidol.

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Section: Discussionsupporting

confidence: 66%

Comparison of the Effect of Quetiapine With Haloperidol in Treatment of Delirium in Icu Patients

2020

jcr

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“…Patients with QTc prolongation were significantly older (age 54±11 v.s 45±17years, p=0.002) and with higher baseline QTc (454±33 vs. 442±30 (p=0.045)). Multivariant analysis revealed only dose as a major factor (OR=1.006 (1.003-1.009), p<0.001) [14]. These results do not support the hypothesis that haloperidol shortens delirium in individuals with serious illnesses.…”

Section: Comparability With Atypical Antipsychoticsmentioning

confidence: 61%

Haloperidol Versus Atypical Antipsychotics for Treating Delirium in Intensive Care Unit Patients: A Systematic Review

Sadhu¹,

Valencia²,

Fatima³

et al. 2022

Cureus

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Delirium is a severe and variable neuropsychiatric illness that causes cognitive and behavioral problems as well as abrupt impairment in consciousness and focus. Due to the complex, dynamic, and multifaceted interactions between several risk factors, the etiology of delirium is unclear. Although its efficacy has not been thoroughly studied, haloperidol, a common antipsychotic medicine, is frequently used to prevent delirium in critically ill patients. When evaluating the atypical antipsychotic response rates for treating delirium, only a few trials have taken age into account.Articles were searched for from PubMed, PubMed Central (PMC), and Science Direct, and reviewed systematically. A complete 225 articles were identified after applying the search strategy to these databases. Out of these, 12 were finalized for review. We reviewed the efficacy and safety of haloperidol with atypical antipsychotics for treating delirium in intensive care unit patients.

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“…In other words, a highly potent antipsychotic such as haloperidol has an overall range of 5-20 mg daily, so ICU patients may require lower doses to control their delirium, which explains the minor differences between initiation and maintenance doses. On the other hand, antipsychotics with lower potency such as quetiapine may require higher doses, particularly higher maintenance doses, which explains the wide overall range (25-800 mg daily) to achieve the same outcomes [30,41].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy and Safety of Quetiapine in the Treatment of Delirium in Adult ICU Patients: A Retrospective Comparative Study

Alghadeer,

Almesned,

Alshehri

et al. 2024

JCM

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Background: Quetiapine is commonly prescribed off-label to manage delirium in intensive care unit (ICU) patients. However, limited studies comparing its efficacy and safety to those of other antipsychotics exist in the literature. Method: A retrospective, single-center chart review study was conducted on adults admitted to the ICU between January 2017 and August 2022, who were diagnosed with delirium and treated with a single antipsychotic and had no neurological medical conditions, active alcohol withdrawal, or prior use of antipsychotics. Data were analyzed using SPSS software version 28, with p-values of <0.05 indicating statistical significance. Results: In total, 47 patients were included, of whom 22 (46.8%), 19 (40.4%), 4 (8.5%), and 2 (4.3%) were on quetiapine, haloperidol, risperidone, and olanzapine, respectively. The median number of hours needed to resolve delirium were 12 (21.5), 23 (28), 13 (13.75), and 36 (10) (p = 0.115) for quetiapine, haloperidol, risperidone, and olanzapine, respectively, with haloperidol being used for a significantly shorter median number of days than quetiapine (3 (2.5) days vs. 7.5 (11.5) days; p = 0.007). Of the medication groups, only quetiapine-treated patients received a significantly higher median maintenance compared to the initiation dose (50 (50) mg vs. 50 (43.75) mg; p = 0.039). For the length of stay in the ICU and hospital, delirium-free days, % of ICU time spent in delirium, ventilator-free days, the difference between the highest and baseline QTc intervals, and ICU and hospital mortalities, no significant difference was observed between the groups. Conclusions: Overall, the use of quetiapine in our retrospective study seems to not be advantageous over the other drugs in terms of efficacy and safety outcomes.

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Evaluating the risk profile of quetiapine in treating delirium in the intensive care adult population: A retrospective review

Cited by 8 publications

References 11 publications

Comparison of the Effect of Quetiapine With Haloperidol in Treatment of Delirium in Icu Patients

Comparison of the Effect of Quetiapine With Haloperidol in Treatment of Delirium in Icu Patients

Haloperidol Versus Atypical Antipsychotics for Treating Delirium in Intensive Care Unit Patients: A Systematic Review

Evaluation of the Efficacy and Safety of Quetiapine in the Treatment of Delirium in Adult ICU Patients: A Retrospective Comparative Study

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