Neither typical nor atypical antipsychotics proved more effective than placebo in shortening the duration of delirium in intensive care units, according to a New England Journal of Medicine study presented at the European Society of Intensive Care Medicine’s Annual Congress.
In the multicenter study, nearly 600 patients developing delirium in the ICU underwent randomization to intravenous doses of haloperidol (up to 20 mg daily), ziprasidone (40 mg), or placebo for up to 14 days. Doses could be adjusted, depending on the patient’s mental state, and the median duration of treatment exposure was 4 days.
The primary outcome — the number of days that patients were free of delirium and coma during the 14-day intervention period — did not differ between those on antipsychotics and those on placebo.
An editorialist comments: “I would still consider using dopamine antagonists in patients at imminent risk of … injurious behaviors, but I would have less confidence in their benefits than I had in the past.”