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

Authors
Yoon, Ho-KyoungKim, Yong-KuHan, ChangsuKo, Young-HoonLee, Heon-JeongKwon, Do-YoungKim, Leen
Issue Date
8월-2011
Publisher
CAMBRIDGE UNIV PRESS
Keywords
delirium; DRS; MDAS; paliperidone
Citation
ACTA NEUROPSYCHIATRICA, v.23, no.4, pp.179 - 183
Indexed
SCIE
SCOPUS
Journal Title
ACTA NEUROPSYCHIATRICA
Volume
23
Number
4
Start Page
179
End Page
183
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/111919
DOI
10.1111/j.1601-5215.2011.00568.x
ISSN
0924-2708
Abstract
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.
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