TY - JOUR
T1 - A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients
AU - Breitbart, William
AU - Marotta, Rocco
AU - Platt, Meredith M.
AU - Weisman, Henry
AU - Derevenco, Maria
AU - Grau, Carmen
AU - Corbera, Kathy
AU - Raymond, Susan
AU - Lund, Stephen
AU - Jacobsen, Paul
PY - 1996/2
Y1 - 1996/2
N2 - Objective: The purpose of this study was to examine the efficacy and side effects of haloperidol, chlorpromazine, and lorazepam for the treatment of the symptoms of delirium in adult AIDS patients in a randomized, double- blind, comparison trial. Method: Nondelirious, medically hospitalized AIDS patients (N=244) consented to participate in the study and were monitored prospectively for the development of delirium. Patients entered the treatment phase of the study if they met DSM-III-R criteria for delirium and scored 13 or greater on the Delirium Rating Scale. Thirty patients were randomly assigned to treatment with haloperidol (N=11), chlorpromazine (N=13), or lorazepam (N=6). Efficacy and side effects associated with the treatment were measured with repeated assessments using the Delirium Rating Scale, the Mini- Mental State, and the Extrapyramidal Symptom Rating Scale. Results: Treatment with either haloperidol or chlorpromazine in relatively low doses resulted in significant improvement in the symptoms of delirium as measured by the Delirium Rating Scale. No improvement in the symptoms of delirium was found in the lorazepam group. Cognitive function, as measured by the Mini-Mental State, improved significantly from baseline to day 2 for patients receiving chlorpromazine. Treatment with haloperidol or chlorpromazine was associated with an extremely low prevalence of extrapyramidal side effects. All patients receiving lorazepam, however, developed treatment-limiting adverse effects. Although only a small number of patients had been treated with lorazepam, the authors became sufficiently concerned with the adverse effects to terminate that arm of the protocol early. Conclusions: Symptoms of delirium in medically hospitalized AIDS patients may he treated efficaciously with few side effects by using low-dose neuroleptics (haloperidol or chlorpromazine). Lorazepam alone appears to be ineffective and associated with treatment- limiting adverse effects.
AB - Objective: The purpose of this study was to examine the efficacy and side effects of haloperidol, chlorpromazine, and lorazepam for the treatment of the symptoms of delirium in adult AIDS patients in a randomized, double- blind, comparison trial. Method: Nondelirious, medically hospitalized AIDS patients (N=244) consented to participate in the study and were monitored prospectively for the development of delirium. Patients entered the treatment phase of the study if they met DSM-III-R criteria for delirium and scored 13 or greater on the Delirium Rating Scale. Thirty patients were randomly assigned to treatment with haloperidol (N=11), chlorpromazine (N=13), or lorazepam (N=6). Efficacy and side effects associated with the treatment were measured with repeated assessments using the Delirium Rating Scale, the Mini- Mental State, and the Extrapyramidal Symptom Rating Scale. Results: Treatment with either haloperidol or chlorpromazine in relatively low doses resulted in significant improvement in the symptoms of delirium as measured by the Delirium Rating Scale. No improvement in the symptoms of delirium was found in the lorazepam group. Cognitive function, as measured by the Mini-Mental State, improved significantly from baseline to day 2 for patients receiving chlorpromazine. Treatment with haloperidol or chlorpromazine was associated with an extremely low prevalence of extrapyramidal side effects. All patients receiving lorazepam, however, developed treatment-limiting adverse effects. Although only a small number of patients had been treated with lorazepam, the authors became sufficiently concerned with the adverse effects to terminate that arm of the protocol early. Conclusions: Symptoms of delirium in medically hospitalized AIDS patients may he treated efficaciously with few side effects by using low-dose neuroleptics (haloperidol or chlorpromazine). Lorazepam alone appears to be ineffective and associated with treatment- limiting adverse effects.
UR - http://www.scopus.com/inward/record.url?scp=9044244135&partnerID=8YFLogxK
U2 - 10.1176/ajp.153.2.231
DO - 10.1176/ajp.153.2.231
M3 - Article
C2 - 8561204
AN - SCOPUS:9044244135
SN - 0002-953X
VL - 153
SP - 231
EP - 237
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 2
ER -