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Neither Haloperidol, Ziprasidone Shortens Delirium in ICU

No decrease in duration versus placebo for patients with hypoactive, hyperactive delirium in ICU

man on respirator

THURSDAY, Oct. 25, 2018 (HealthDay News) -- For patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the intensive care unit, neither haloperidol nor ziprasidone alters the duration of delirium compared with placebo, according to a study published online Oct. 22 in the New England Journal of Medicine.

Timothy D. Girard, M.D., from the University of Pittsburgh School of Medicine, and colleagues randomly assigned 566 patients with acute respiratory failure or shock and hypoactive or hyperactive delirium to receive intravenous boluses of haloperidol, ziprasidone, or placebo (192, 190, and 184 patients, respectively).

The researchers found that patients were exposed to a trial drug or placebo for a median duration of four days. The median number of days alive without delirium or coma was 8.5, 7.9, and 8.7 in the placebo, haloperidol, and ziprasidone groups (P = 0.26 for overall effect across trial groups). Compared with placebo, use of haloperidol or ziprasidone had no significant effect on the primary end point of number of days alive without delirium or coma during the 14-day intervention period (odds ratios, 0.88 [95 percent confidence interval, 0.64 to 1.21] and 1.04 [95 percent confidence interval, 0.73 to 1.48], respectively).

"We found, after extensive investigation with medical centers all over the country, that the patients who get these potentially dangerous drugs are not experiencing any improvements whatsoever in delirium, coma, length of stay, or survival," one of the authors said in a statement.

Several authors disclosed ties to the pharmaceutical industry.

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