• J Palliat Med · Jun 2023

    Observational Study

    Chlorpromazine's Potential Role in Palliating Distressing Symptoms Associated with Hyperactive Delirium in Patients at End of Life.

    • Casey M Tiefenthaler, Jeremy M Hirst, Kyle P Edmonds, and Rabia S Atayee.
    • Department of Pharmacy, University of California Health, La Jolla, California, USA.
    • J Palliat Med. 2023 Jun 1; 26 (6): 826830826-830.

    AbstractBackground: The hyperactive subtype of delirium is characterized by agitation, restlessness, delusions, and/or hallucinations, which commonly present near end of life (EoL). Symptom relief often requires the use of medications, such as chlorpromazine (CPZ), to reduce patient distress by inducing proportional sedation. Objective: The purpose of this study was to evaluate CPZ's potential role in managing the distress of hyperactive delirium in patients receiving EoL care. Methods: A retrospective observational study among hospitalized patients with advanced cancer at EoL between January 2020 to December 2021. Results: Sustained improvement in symptoms of delirium was seen in 80% of patients as identified in the palliative psychiatrist's progress notes. Meanwhile, 75% of patient's improvement was reported in nursing-driven Delirium Observation Screening Scale. Conclusion: This study elucidates that at doses of ∼100 mg/day, CPZ is potentially an effective medication for patients with advanced cancer, experiencing hyperactive delirium in their final week of life.

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