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Paliperidone in the treatment of delirium: results of a prospective open-label pilot trial

Published online by Cambridge University Press:  24 June 2014

Ho-Kyoung Yoon ,
Yong-Ku Kim ,
Changsu Han ,
Young-Hoon Ko ,
Heon-Jeong Lee ,
Do-Young Kwon  and
Leen Kim
Ho-Kyoung Yoon
Affiliation:
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
Yong-Ku Kim
Affiliation:
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
Changsu Han
Affiliation:
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
Young-Hoon Ko
Affiliation:
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
Heon-Jeong Lee
Affiliation:
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
Do-Young Kwon
Affiliation:
Department of Neurology, College of Medicine, Korea University, Seoul, South Korea
Leen Kim*
Affiliation:
Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
*
Professor Leen Kim, Department of Psychiatry, College of Medicine, Korea University Anam Hospital, Anam-Dong, Sungbuk-Gu, Seoul 136-705, South Korea. Tel: +82 2 920 5815; Fax: +82 2 927 2836; E-mail: because@naver.com
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Extract

Yoon H-K, Kim Y-K, Han C, Ko Y-H, Lee H-J, Kwon D-Y, Kim L. Paliperidone in the treatment of delirium: results of a prospective open-label pilot trial.

Objective: Delirium is a life-threatening neuropsychiatric syndrome characterised by disturbances in consciousness, attention, cognition and perception. Antipsychotics are considered the drugs of choice in managing the symptoms of delirium. Paliperidone is a benzisoxazole derivative and the principal active metabolite of risperidone. In this study, we aimed to evaluate the efficacy of paliperidone for the treatment of delirium.

Methods: A prospective open-label study of paliperidone for delirium treatment was performed with 6-day follow-up. Fifteen patients who met Diagnostic and Statistical Manual of Mental disorders, Fourth Edition criteria for delirium and had a score of 13 on the Delirium Rating Scale were recruited. The starting dose was 3 mg once a day and the dose was adjusted depending on the status of delirium. Daily assessments of the severity of delirium were evaluated using Memorial Delirium Assessment Scale (MDAS).

Results: The mean daily maintenance dose of paliperidone was 3.75 ± 1.06. The MDAS scores before and after treatment (day 7) were 23.60 ± 6.31 and 11.33 ± 5.45 (t = 6.78, p < 0.001), respectively. The intensity of delirium showed a statistically significant reduction in MDAS scores from the first day of treatment. No serious adverse effects were observed, and none of the patients discontinued paliperidone because of adverse effects.

Conclusions: This study shows that low-dose paliperidone is effective in reducing behavioural disturbances and symptoms in delirium and is well tolerated in delirious patients. This trial is an open-label study with a small sample size, and further controlled studies will be necessary.

Keywords

deliriumDRSMDASpaliperidone
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 23 , Issue 4 , August 2011 , pp. 179 - 183
Copyright
Copyright © Cambridge University Press 2011

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