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Table 2 Clinical trials evaluating antipsychotics in critically ill patients with delirium.

From: Delirium in the ICU: an overview

Author, year No. of patients Inclusion criteria Interventions Blinding Randomization Primary endpoint Results
Reade [84], 2009 20 Mechanical ventilation, inability to extubate because of agitation Dexmedetomidine 0.2-0.7 mcg/kg/h (loading dose was optional) Haloperidol 0.5-2 mg/h (loading dose was optional) No Computer-generated random sequence Time from commencement of study drug to extubation Patients on dexmedetomidine were extubated sooner than those on haloperidol: 9.9 (IQR 7.3-24) vs. 42.5 (IQR 23.2-117.8) hours, P = 0.016.
Girard [85], 2010 101 Mechanical ventilation, abnormal level of consciousness, receipt of sedative or analgesic medications Haloperidol 5 mg Ziprasidone 40 mg placebo. Second dose administered 12 hours after the first if QT < 500 msec; then every 6 hours. Yes Computer-generated, permuted-block randomization scheme Number of days alive without delirium or coma No significant difference in number of days alive without delirium or coma. P = 0.66. Haloperidol: 14 (IQR 6–18) days Ziprasidone: 15 (IQR 9.1-18) days Placebo: 12.5 (IQR 1.2-17.2) days
Devlin [86], 2010 36 ICU patients with delirium and an order for as-needed haloperidol Quetiapine 50 mg every 12 hours titrated upwards on a daily basis if haloperidol was needed. Placebo. Yes Computer-generated random sequence Time to first resolution of delirium Time to first resolution was shorter with Quetiapine therapy than with placebo, P = 0.001. Quetiapine: 1 (IQR 0.5-3) days Placebo: 4.5 (IQR 2–7) days
Skrobik [87], 2004 73 ICU patients with delirium Haloperidol 2.5-5 mg every 8 hours Olanzapine 5 mg daily Only those assessing outcomes Even/odds day basis Not specified No difference in delirium index scores, P = 0.83. No difference in benzodiazepine use, P = 0.9.
  1. IQR, interquartile range.