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

Authors: Breitbart, W.; Tremblay, A.; Gibson, C.
Article Title: An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients
Abstract: 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.
Keywords: adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; drowsiness; drug efficacy; drug safety; cancer patient; prospective studies; neoplasms; nausea; logistic models; olanzapine; delirium; extrapyramidal symptom; risk factors; risk factor; pruritus; rash; severity of illness index; rating scale; chi-square distribution; headache; logistic regression analysis; analysis of variance; visual impairment; vertigo; inpatients; memorial delirium assessment scale; antipsychotic agents; benzodiazepines; stomach pain; humans; prognosis; human; male; female; article; pirenzepine
Journal Title: Psychosomatics
Volume: 43
Issue: 3
ISSN: 0033-3182
Publisher: Elsevier Science, Inc.  
Date Published: 2002-05-01
Start Page: 175
End Page: 182
Language: English
DOI: 10.1176/appi.psy.43.3.175
PUBMED: 12075032
PROVIDER: scopus
Notes: Export Date: 14 November 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. William S Breitbart
    414 Breitbart
  2. Christopher A Gibson
    12 Gibson