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M9650341.TXT
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1996-03-09
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Document 0341
DOCN M9650341
TI A double-blind trial of haloperidol, chlorpromazine, and lorazepam in
the treatment of delirium in hospitalized AIDS patients.
DT 9605
AU Breitbart W; Marotta R; Platt MM; Weisman H; Derevenco M; Grau C;
Corbera K; Raymond S; Lund S; Jacobson P; Department of Neurology,
Memorial Sloan-Kettering Cancer Center,; New York, NY 10021, USA.
SO Am J Psychiatry. 1996 Feb;153(2):231-7. Unique Identifier : AIDSLINE
MED/96155935
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 be
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.
DE Adult AIDS Dementia Complex/DIAGNOSIS/*DRUG THERAPY Basal Ganglia
Diseases/CHEMICALLY INDUCED/EPIDEMIOLOGY Chlorpromazine/ADVERSE
EFFECTS/*THERAPEUTIC USE Comparative Study Delirium/DIAGNOSIS/*DRUG
THERAPY Double-Blind Method Drug Administration Schedule Female
Haloperidol/ADVERSE EFFECTS/*THERAPEUTIC USE *Hospitalization Human
Lorazepam/ADVERSE EFFECTS/*THERAPEUTIC USE Male Middle Age Prevalence
Psychiatric Status Rating Scales Severity of Illness Index Support,
U.S. Gov't, P.H.S. Treatment Outcome CLINICAL TRIAL JOURNAL ARTICLE
RANDOMIZED CONTROLLED TRIAL
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).