A Prospective, Open-Label, Flexible-Dose Study of Quetiapine in the Treatment of Delirium
J Clin Psychiatry 2003;64:1316-1321
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Delirium is an organic psychiatric
syndrome characterized by fluctuating consciousness and impaired
cognitive functioning. High-potency typical neuroleptics have
traditionally been used as first-line drugs in the treatment of
delirium. However, these drugs are frequently associated with
undesirable adverse events including extrapyramidal symptoms
(EPS). The purpose of the present open-label, flexible-dose study
was to provide preliminary data on the usefulness and safety of
quetiapine for patients with delirium.
Method: Twelve patients with DSM-IV delirium
were treated with flexible doses of open-label quetiapine (mean
± SD dosage = 44.9 ± 31.0 mg/day). To evaluate the usefulness
and safety of quetiapine, scores from the Delirium Rating Scale,
Japanese version, were assessed every day (for 1 outpatient, at
least twice per week), and scores from the Mini-Mental State
Examination, Japanese version, and the Drug-Induced
Extrapyramidal Symptom Scale were assessed at baseline and after
remission of delirium. Data were gathered from April to October
Results: All patients achieved remission of
delirium several days after starting quetiapine (mean ± SD
duration until remission = 4.8 ± 3.5 days). Quetiapine treatment
was well tolerated, and no clinically relevant change in EPS was
Conclusion: Quetiapine may be a useful
alternative to conventional neuroleptics in the treatment of
delirium due to its rapid onset and relative lack of adverse
events. Further double-blind, placebo-controlled studies are