Department of Consultation Liaison Psychiatry and Medical Psychiatry, Bellevue Hospital Center, New York, New York 10016, USA.
Aust N Z J Psychiatry. 2011 Jun;45(6):477-82. doi: 10.3109/00048674.2011.543411.
To compare the efficacy and tolerability of aripiprazole and haloperidol in the amelioration of distressing symptoms of delirium and its motoric subtypes.
At Memorial Sloan-Kettering Cancer Center, we prospectively collected sociodemographic and medical data and systematically rated all patients diagnosed with delirium with the Memorial Delirium Assessment Scale (MDAS), Karnofsky Performance Scale (KPS) and the abbreviated Udvalg Kliniske Undersogelser Side Effect Rating Scale (UKU) at the initial diagnosis of delirium (T1), after 48-72 h (T2) and 7 days later (T3). All collected information was entered into a delirium database. For our analysis, we subsequently extracted data on aripiprazole (ARI) treated patients to compare to case-matched haloperidol (HAL) treated patients.
We retrieved 21 patients treated with aripiprazole and 21 case-matched patients treated with haloperidol. Initial MDAS scores did not significantly differ between the groups. Over the course of treatment (T1 to T3), MDAS scores improved from 18.1 to 8.3 for ARI and 19.9 to 6.8 for HAL. The delirium resolution rate was 76.2% for ARI and 76.2% for HAL. For patients with hypoactive delirium, the MDAS scores improved from 15.6 to 5.7 for ARI and 18.8 to 8.1 for HAL. Delirium resolution rates for patients with hypoactive delirium were 100% for ARI and 77.8% for HAL. For patients experiencing hyperactive delirium, the MDAS scores improved from 19.9 to 6.8 for ARI and 20.8 to 5.8 for HAL. Delirium resolution rates for patients with hyperactive delirium were 58.3% for ARI and 75% for HAL. There were no significant differences in treatment results between ARI and HAL. Treatment with HAL caused more extrapyramidal side effects.
From our secondary analysis, aripiprazole may be as effective as haloperidol in the management of delirium and its subtypes. Treatment with haloperidol resulted in more side effects.
比较阿立哌唑和氟哌啶醇在改善谵妄痛苦症状及其运动障碍亚型方面的疗效和耐受性。
在纪念斯隆-凯特琳癌症中心，我们前瞻性地收集了社会人口统计学和医学数据，并在谵妄的初始诊断（T1）、48-72 小时后（T2）和 7 天后（T3）使用纪念谵妄评估量表（MDAS）、卡诺夫斯基表现量表（KPS）和简化的 Udvalg Kliniske Undersogelser 副作用评定量表（UKU）对所有诊断为谵妄的患者进行系统评分。所有收集到的信息都被输入到一个谵妄数据库中。在我们的分析中，我们随后提取了接受阿立哌唑（ARI）治疗的患者的数据，并与接受氟哌啶醇（HAL）治疗的病例匹配患者进行比较。
我们共检索到 21 例接受阿立哌唑治疗的患者和 21 例接受氟哌啶醇治疗的病例匹配患者。两组患者的初始 MDAS 评分无显著差异。在治疗过程中（T1 至 T3），ARI 的 MDAS 评分从 18.1 分降至 8.3 分，HAL 的 MDAS 评分从 19.9 分降至 6.8 分。ARI 和 HAL 的谵妄缓解率分别为 76.2%和 76.2%。对于低活动型谵妄患者，ARI 的 MDAS 评分从 15.6 分降至 5.7 分，HAL 的 MDAS 评分从 18.8 分降至 8.1 分。低活动型谵妄患者的谵妄缓解率分别为 100%和 77.8%。对于高活动型谵妄患者，ARI 的 MDAS 评分从 19.9 分降至 6.8 分，HAL 的 MDAS 评分从 20.8 分降至 5.8 分。高活动型谵妄患者的谵妄缓解率分别为 58.3%和 75%。ARI 和 HAL 的治疗结果无显著差异。HAL 治疗引起更多的锥体外系副作用。
从我们的二次分析来看，阿立哌唑在治疗谵妄及其亚型方面可能与氟哌啶醇同样有效。氟哌啶醇治疗导致更多的副作用。
