An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients

被引:180
作者
Breitbart, W
Tremblay, A
Gibson, C
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Psychiat & Behav Sci, Psychiat Serv, New York, NY 10021 USA
[2] Hop Hotel Dieu, Dept Psychiat, Quebec City, PQ, Canada
关键词
D O I
10.1176/appi.psy.43.3.175
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
We conducted an open, prospective trial of olanzapine for the treatment of delirium in a sample of 79 hospitalized cancer patients. Patients all met DSM-IV criteria for a diagnosis of delirium and were rated systematically with the Memorial Delirium Assessment Scale (MDAS) as a measure of delirium severity, phenomenology, and resolution, over the course of a 7-day treatment period. Sociodemographic and medical variables and measures of physical performance status and drug-related side effects were collected. Fifty-seven patients (76%) had complete resolution of their delirium on olanzapine therapy. No patients experienced extrapyramidal side effects; however, 30% experienced sedation (usually, not severe enough to interrupt treatment). Several factors were found to be significantly associated with poorer response to olanzapine treatment for delirium, including age >70 years, history of dementia, central nervous system spread of cancer and hypoxia as delirium etiologies, "hypoactive" delirium, and delirium of "severe" intensity (i.e., MDAS >23). A logistic-regression model suggests that age >70 years is the most powerful predictor of poorer response to olanzapine treatment for delirium (odds ratio, 171.5). Olanzapine appears to be a clinically efficacious and safe drug for the treatment of the symptoms of delirium in the hospitalized medically ill.
引用
收藏
页码:175 / 182
页数:8
相关论文
共 44 条
[1]  
Anand HS, 1999, CAN J PSYCHIAT, V44, P397
[2]   The Memorial Delirium Assessment Scale [J].
Breitbart, W ;
Rosenfeld, B ;
Roth, A ;
Smith, MJ ;
Cohen, K ;
Passik, S .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1997, 13 (03) :128-137
[3]   NEUROPSYCHIATRIC SYNDROMES AND PSYCHOLOGICAL SYMPTOMS IN PATIENTS WITH ADVANCED CANCER [J].
BREITBART, W ;
BRUERA, E ;
CHOCHINOV, H ;
LYNCH, M .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1995, 10 (02) :131-141
[4]  
Breitbart W, 1996, AM J PSYCHIAT, V153, P231
[5]   Delirium in the terminally ill [J].
Breitbart, W ;
Strout, D .
CLINICS IN GERIATRIC MEDICINE, 2000, 16 (02) :357-+
[6]   THE ASSESSMENT OF PAIN INTENSITY IN PATIENTS WITH COGNITIVE FAILURE - A PRELIMINARY-REPORT [J].
BRUERA, E ;
FAINSINGER, RL ;
MILLER, MJ ;
KUEHN, N .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1992, 7 (05) :267-270
[7]   DELIRIUM AS A CONTRIBUTING FACTOR TO CRESCENDO PAIN - 3 CASE-REPORTS [J].
COYLE, N ;
BREITBART, W ;
WEAVER, S ;
PORTENOY, R .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1994, 9 (01) :44-47
[8]   A randomized trial of risperidone, placebo, and haloperidol for behavioral symptoms of dementia [J].
De Deyn, PP ;
Rabheru, K ;
Rasmussen, A ;
Bocksberger, JP ;
Dautzenberg, PLJ ;
Eriksson, S ;
Lawlor, BA .
NEUROLOGY, 1999, 53 (05) :946-955
[9]   A randomized, placebo-controlled dose-comparison trial of haloperidol for psychosis and disruptive behaviors in Alzheimer's disease [J].
Devanand, DP ;
Marder, K ;
Michaels, KS ;
Sackeim, HA ;
Bell, K ;
Sullivan, MA ;
Cooper, TB ;
Pelton, GH ;
Mayeux, R .
AMERICAN JOURNAL OF PSYCHIATRY, 1998, 155 (11) :1512-1520
[10]  
Goodnick P J, 2001, Expert Opin Pharmacother, V2, P667, DOI 10.1517/14656566.2.4.667