Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes
INTRODUCTION Delirium has been recognised as an underdiagnosed and undermanaged syndrome with substantial prevalence rates and potentially deleterious consequences in the medically ill population. Despite its frequent administration in the management of delirium, the effectiveness of pip...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2017-07-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2333 |
| _version_ | 1797979686053085184 |
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| author | Soenke Boettger Silvana Knoepfel Maria Schubert David Garcia Nuñez Michael Martin Plichta Richard Klaghofer Josef Jenewein |
| author_facet | Soenke Boettger Silvana Knoepfel Maria Schubert David Garcia Nuñez Michael Martin Plichta Richard Klaghofer Josef Jenewein |
| author_sort | Soenke Boettger |
| collection | DOAJ |
| description |
INTRODUCTION
Delirium has been recognised as an underdiagnosed and undermanaged syndrome with substantial prevalence rates and potentially deleterious consequences in the medically ill population. Despite its frequent administration in the management of delirium, the effectiveness of pipamperone has not yet been evaluated.
METHODS
In this retrospective, descriptive cohort study of 192 patients, pipamperone as monotherapy and as an adjunct to haloperidol, haloperidol alone, or atypical antipsychotics were compared with respect to their effectiveness in the management of delirium and its subtypes over the course of 20 days.
RESULTS
In this elderly patient population, pipamperone alone and as an adjunct to haloperidol was as effective as haloperidol or atypical antipsychotics in the management of delirium. Management with low-dose pipamperone monotherapy achieved delirium resolution in 70% of patients, over a mean of 6.4 (2–20) days. With pipamperone as an adjunct to haloperidol, delirium resolved in 59% of patients, over a mean of 7.4 (2–20) days. When haloperidol or atypical antipsychotics (risperidone, olanzapine or quetiapine) were used, the delirium resolution rates were 72 and 67%, over a mean of 5.2 (2–11) and 6.4 (2–20) days, respectively. The addition of pipamperone to haloperidol decreased the requirement for lorazepam. Pipamperone proved to be equally effective in all delirium subtypes – hypoactive, hyperactive and mixed. Nonetheless, potential bias could not be excluded in this observational design.
CONCLUSION
From these initial results, low-dose pipamperone was as effective as haloperidol or atypical antipsychotics in the management of delirium and its subtypes, and was benzodiazepine-sparing when used as an adjunct to haloperidol.
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| first_indexed | 2024-04-11T05:43:49Z |
| format | Article |
| id | doaj.art-b403b61dce5744db92636acd686057e4 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T05:43:49Z |
| publishDate | 2017-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-b403b61dce5744db92636acd686057e42022-12-22T04:42:22ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972017-07-01147293010.4414/smw.2017.14471Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypesSoenke Boettger0Silvana Knoepfel1Maria Schubert2David Garcia Nuñez3Michael Martin Plichta4Richard Klaghofer5Josef Jenewein6Department of Psychiatry and Psychotherapy, University of Zurich, University Hospital Zurich, SwitzerlandDepartment of Psychiatry and Psychotherapy, University of Zurich, University Hospital Zurich, SwitzerlandCentre of Clinical Nursing Science, University of Zurich, University Hospital Zurich, Switzerland; Directorate of Nursing/MTT, Inselspital, University Hospital Bern, SwitzerlandUniversity Basel, University Hospital Basel, SwitzerlandDepartment of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Frankfurt, GermanyDepartment of Psychiatry and Psychotherapy, University of Zurich, University Hospital Zurich, SwitzerlandDepartment of Psychiatry and Psychotherapy, University of Zurich, University Hospital Zurich, Switzerland INTRODUCTION Delirium has been recognised as an underdiagnosed and undermanaged syndrome with substantial prevalence rates and potentially deleterious consequences in the medically ill population. Despite its frequent administration in the management of delirium, the effectiveness of pipamperone has not yet been evaluated. METHODS In this retrospective, descriptive cohort study of 192 patients, pipamperone as monotherapy and as an adjunct to haloperidol, haloperidol alone, or atypical antipsychotics were compared with respect to their effectiveness in the management of delirium and its subtypes over the course of 20 days. RESULTS In this elderly patient population, pipamperone alone and as an adjunct to haloperidol was as effective as haloperidol or atypical antipsychotics in the management of delirium. Management with low-dose pipamperone monotherapy achieved delirium resolution in 70% of patients, over a mean of 6.4 (2–20) days. With pipamperone as an adjunct to haloperidol, delirium resolved in 59% of patients, over a mean of 7.4 (2–20) days. When haloperidol or atypical antipsychotics (risperidone, olanzapine or quetiapine) were used, the delirium resolution rates were 72 and 67%, over a mean of 5.2 (2–11) and 6.4 (2–20) days, respectively. The addition of pipamperone to haloperidol decreased the requirement for lorazepam. Pipamperone proved to be equally effective in all delirium subtypes – hypoactive, hyperactive and mixed. Nonetheless, potential bias could not be excluded in this observational design. CONCLUSION From these initial results, low-dose pipamperone was as effective as haloperidol or atypical antipsychotics in the management of delirium and its subtypes, and was benzodiazepine-sparing when used as an adjunct to haloperidol. https://www.smw.ch/index.php/smw/article/view/2333AntipsychoticsDeliriumeffectivenesshaloperidolpipamperone |
| spellingShingle | Soenke Boettger Silvana Knoepfel Maria Schubert David Garcia Nuñez Michael Martin Plichta Richard Klaghofer Josef Jenewein Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes Swiss Medical Weekly Antipsychotics Delirium effectiveness haloperidol pipamperone |
| title | Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes |
| title_full | Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes |
| title_fullStr | Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes |
| title_full_unstemmed | Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes |
| title_short | Pipamperone and delirium: a preliminary evaluation of its effectiveness in the management of delirium and its subtypes |
| title_sort | pipamperone and delirium a preliminary evaluation of its effectiveness in the management of delirium and its subtypes |
| topic | Antipsychotics Delirium effectiveness haloperidol pipamperone |
| url | https://www.smw.ch/index.php/smw/article/view/2333 |
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