Delirium Clinical Trial
Official title:
Haloperidol vs Olanzapine for the Management of ICU Delirium: A Randomized Clinical Trial
The purpose of this randomized clinical trial is to determine whether haloperidol is superior to olanzapine for the treatment of ICU acquired delirium. The hypothesis is that haloperidol is in fact superior to olanzapine in treating ICU acquired delirium and sustaining delirium free time.
Delirium is defined as a disturbance of consciousness characterized by an acute onset of
impaired cognitive function. Although delirium is thought to be common in the Intensive Care
Unit (ICU) there are few studies that have evaluated its incidences, risks and outcomes. It
has been associated with increased morbidity, and mortality and increased cost to the
healthcare system. In addition to the uncertainty of the incidence of ICU delirium, there is
a lack of information about the effects that certain pharmacological treatments have on
delirious patients.
The standard pharmacological treatments for ICU acquired delirium are haloperidol and
olanzapine as they have been shown to be equivalent in reducing its incidence. However,
optimal dose and regimen have not been well defined.
The rationale for this study is to determine whether haloperidol is superior to olanzapine
in the treatment of ICU acquired delirium. A secondary objective is to determine the most
appropriate dosing regimen for the treatmet. The role of alternative agents quetiapine,
risperidone, loxapine and methotrimeprazine will also be examined in a preliminary analysis.
Patients who develop agitation or delirium as defined by an Intensive Care Delirium
Checklist (ICDSC) score of greater than or equal to 4 meeting all the inclusion criteria and
no exclusion criteria will be eligible for randomization. Once randomized they will be
screened for ongoing agitation and delirium as well prolongation of the QTc interval greater
than 440 msec, development of extrapyramidal symptoms and development of a seizure disorder.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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