Document 0341
 DOCN  M9650341
 TI    A double-blind trial of haloperidol, chlorpromazine, and lorazepam in
       the treatment of delirium in hospitalized AIDS patients.
 DT    9605
 AU    Breitbart W; Marotta R; Platt MM; Weisman H; Derevenco M; Grau C;
       Corbera K; Raymond S; Lund S; Jacobson P; Department of Neurology,
       Memorial Sloan-Kettering Cancer Center,; New York, NY 10021, USA.
 SO    Am J Psychiatry. 1996 Feb;153(2):231-7. Unique Identifier : AIDSLINE
       MED/96155935
 AB    OBJECTIVE: The purpose of this study was to examine the efficacy and
       side effects of haloperidol, chlorpromazine, and lorazepam for the
       treatment of the symptoms of delirium in adult AIDS patients in a
       randomized, double-blind, comparison trial. METHOD: Nondelirious,
       medically hospitalized AIDS patients (N = 244) consented to participate
       in the study and were monitored prospectively for the development of
       delirium. Patients entered the treatment phase of the study if they met
       DSM-III-R criteria for delirium and scored 13 or greater on the Delirium
       Rating Scale. Thirty patients were randomly assigned to treatment with
       haloperidol (N = 11), chlorpromazine (N = 13), or lorazepam (N = 6).
       Efficacy and side effects associated with the treatment were measured
       with repeated assessments using the Delirium Rating Scale, the
       Mini-Mental State, and the Extrapyramidal Symptom Rating Scale. RESULTS:
       Treatment with either haloperidol or chlorpromazine in relatively low
       doses resulted in significant improvement in the symptoms of delirium as
       measured by the Delirium Rating Scale. No improvement in the symptoms of
       delirium was found in the lorazepam group. Cognitive function, as
       measured by the Mini-Mental State, improved significantly from baseline
       to day 2 for patients receiving chlorpromazine. Treatment with
       haloperidol or chlorpromazine was associated with an extremely low
       prevalence of extrapyramidal side effects. All patients receiving
       lorazepam, however, developed treatment-limiting adverse effects.
       Although only a small number of patients had been treated with
       lorazepam, the authors became sufficiently concerned with the adverse
       effects to terminate that arm of the protocol early. CONCLUSIONS:
       Symptoms of delirium in medically hospitalized AIDS patients may be
       treated efficaciously with few side effects by using low-dose
       neuroleptics (haloperidol or chlorpromazine). Lorazepam alone appears to
       be ineffective and associated with treatment-limiting adverse effects.
 DE    Adult  AIDS Dementia Complex/DIAGNOSIS/*DRUG THERAPY  Basal Ganglia
       Diseases/CHEMICALLY INDUCED/EPIDEMIOLOGY  Chlorpromazine/ADVERSE
       EFFECTS/*THERAPEUTIC USE  Comparative Study  Delirium/DIAGNOSIS/*DRUG
       THERAPY  Double-Blind Method  Drug Administration Schedule  Female
       Haloperidol/ADVERSE EFFECTS/*THERAPEUTIC USE  *Hospitalization  Human
       Lorazepam/ADVERSE EFFECTS/*THERAPEUTIC USE  Male  Middle Age  Prevalence
       Psychiatric Status Rating Scales  Severity of Illness Index  Support,
       U.S. Gov't, P.H.S.  Treatment Outcome  CLINICAL TRIAL  JOURNAL ARTICLE
       RANDOMIZED CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).