Department of Psychiatry, Mental Health Center of Frosinone, Local Health Authority of Frosinone, Frosinone, Italy.
Department of Psychiatry, Mental Health Center of Viterbo, Local Health Authority of Viterbo, Viterbo, Italy.
J Psychopharmacol. 2024 Jun;38(6):507-514. doi: 10.1177/02698811241249648. Epub 2024 Apr 30.
Delirium is a neuropsychiatric condition that commonly occurs in medical settings, especially among older individuals. Despite the lack of strong evidence in the literature, haloperidol is considered the first-line pharmacological intervention. Unfortunately, its adverse effects can be severe, and psychiatrists are considering the use of alternative drugs targeting dopamine and serotonin domains (atypical antipsychotics). Among them, aripiprazole is considered to have one of the safest pharmacological profiles.
The purpose of this study is to examine the studies on aripiprazole as a pharmacological treatment of delirium present in today's literature.
We carried out systematic research of MedLine, PubMed, Cochrane, Embase, and ScienceDirect examining articles written between January 2002 and September 2023, including experimental studies published in peer-reviewed journals.
The 6 final included studies examined a total of 130 patients, showing a delirium resolution in a 7-day span of 73.8% of patients treated with aripiprazole.
Considering the limited data currently available, we can assert that aripiprazole is at least as efficient as haloperidol, the true point is that it has a far better tolerability and safety profile. Nonetheless, further studies are necessary to provide more compelling data, together with a more precise indication regarding minimum efficient dose, as the main limitations of our review are the very small sample size, the small percentage of subjects with preexisting dementia, and the fact that most studies used scales with low specificity for the examined condition.
谵妄是一种常见于医疗环境中的神经精神疾病，尤其在老年人中更为常见。尽管文献中缺乏强有力的证据，但氟哌啶醇被认为是一线的药物干预手段。然而，其不良反应可能很严重，精神科医生正在考虑使用针对多巴胺和 5-羟色胺能领域的替代药物（非典型抗精神病药）。其中，阿立哌唑被认为具有最安全的药理学特性之一。
本研究旨在检查当今文献中关于阿立哌唑作为谵妄药物治疗的研究。
我们对 MedLine、PubMed、Cochrane、Embase 和 ScienceDirect 进行了系统的研究，查阅了 2002 年 1 月至 2023 年 9 月期间发表的同行评议期刊上的实验研究。
最终纳入的 6 项研究共纳入了 130 名患者，接受阿立哌唑治疗的患者在 7 天内谵妄缓解率为 73.8%。
考虑到目前有限的数据，我们可以断言阿立哌唑至少与氟哌啶醇同样有效，关键是它具有更好的耐受性和安全性。然而，需要进一步的研究来提供更有说服力的数据，并就最小有效剂量提供更精确的指示，因为我们的综述主要存在以下局限性：样本量非常小、患有预先存在的痴呆症的受试者比例较小，以及大多数研究使用的量表对所检查的病症特异性较低。
