Treatment of Delirium—A Reappraisal

Abstract

Delirium is a frequently encountered clinical syndrome which can pose serious problems for the physician and patient. Numerous etiological possibilities exist, and each case is usually associated with multiple causal factors. Although the pathophysiology is poorly understood, the clinical presentation is marked either by stupor and hypoarousal or agitation and hyperarousal. Both types of delirium must be treated by searching for and correcting reversible causative factors. In addition, medication may be quite efficacious in managing the clinical aspects of agitated delirium. Most cases of agitated delirium are either of the "sensory overload" or "sensory deprivation" type. The drug treatment of each is discussed with reference to their respective central nervous system physiological correlates.

Psychobiology of Altered States of Consciousness.

“…This deficit is hypothesized to cause sensory overload in schizophrenic patients and successively lead to disorganization and thought disorders (Ludwig, 1972; Ludwig & Stark, 1973). A cluster of psychiatric symptoms that are unique to the intensive care unit environment have been suggested to be caused, among other reasons, by sensory overload or monotony (Glide, 1994; Steinhart, 1978; Vasquez & Chitwood, 1975). The effects of sleep deprivation on physiological and immune system functions have been discussed as one starting condition for sensory overload in the intensive care unit (Halm & Alpen, 1993; Schwab, 1994).…”