Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium.
Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium.
J Am Med Dir Assoc. 2021 Jun;22(6):1313-1316.e2. doi: 10.1016/j.jamda.2020.12.037. Epub 2021 Feb 5.
The purpose of this report was to identify medications that can be used to treat hypoactive delirium.
A systematic search of PubMed and Web of Science from inception through September 20, 2020.
Reports evaluating different pharmacologic treatments for hypoactive delirium in adults (age 18 years and older) and geriatric patients were included.
Three independent investigators reviewed the abstracts, using the Rayyan QCRI review tool to decide which articles were eligible for inclusion. Hereafter, articles were read completely for final inclusion. Study quality was assessed using the guidelines from the National Institute for Health and Care Excellence for cohort studies and randomized control trials.
Of the 52 relevant articles, only 4 (8%) met the selection criteria. Two were cohort studies whereas the other 2 were randomized control trials. After further review, one of the reports was excluded because the same data were used as in one of the randomized control trials. In total, 4 different pharmacologic therapies were used in the selected studies: haloperidol, ziprasidone, aripiprazole, and methylphenidate. Aripiprazole showed a complete resolution of hypoactive delirium (P < .001), and methylphenidate showed a significant amelioration in cognitive function (P < .001). Ziprasidone and haloperidol did not show significant differences compared with placebo.
A limited number of clinical studies on the treatment of hypoactive delirium are available. Aripiprazole and methylphenidate showed promising results in the treatment of hypoactive delirium.
本报告旨在确定可用于治疗低动力性谵妄的药物。
系统检索 PubMed 和 Web of Science 从成立到 2020 年 9 月 20 日的文献。
评估不同药物治疗成人（18 岁及以上）和老年患者低动力性谵妄的报告均包括在内。
三位独立的研究者使用 Rayyan QCRI 审查工具审查摘要，以确定哪些文章符合纳入标准。此后，对文章进行完整阅读以最终纳入。使用国家卫生与保健卓越研究所（National Institute for Health and Care Excellence）针对队列研究和随机对照试验的指南评估研究质量。
在 52 篇相关文章中，只有 4 篇（8%）符合选择标准。其中 2 篇为队列研究，其余 2 篇为随机对照试验。进一步审查后，由于同一份数据被用于其中一项随机对照试验，其中一份报告被排除。在选定的研究中，共使用了 4 种不同的药物治疗方法：氟哌啶醇、齐拉西酮、阿立哌唑和哌甲酯。阿立哌唑显示低动力性谵妄完全缓解（P<.001），哌甲酯显示认知功能显著改善（P<.001）。齐拉西酮和氟哌啶醇与安慰剂相比无显著差异。
关于低动力性谵妄治疗的临床研究数量有限。阿立哌唑和哌甲酯在治疗低动力性谵妄方面显示出良好的效果。
