• W Anthony Hawkins, Stephanie V Phan, and Stacey L Campbell.
• Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, 1000 Jefferson Street, Albany, GA, USA; Department of Pharmacology and Toxicology, Medical College of Georgia at Augusta University, 1000 Jefferson Street, Albany, GA, USA. Electronic address: hawkins@uga.edu.
• J Crit Care. 2018 Apr 1; 44: 289-293.

PurposeDelirium is common during critical illness but it is unknown whether the choice of antipsychotic or dosing strategy impacts delirium outcomes. We evaluated the incidence of delirium in critically ill adults receiving different antipsychotic regimens.Materials And MethodsSingle center retrospective cohort study of adult patients admitted to the intensive care unit (ICU). Patients who received haloperidol or quetiapine and scored negative on the Confusion Assessment Method for the ICU (CAM-ICU) prior to initiation were included. Patients were divided into four groups based on dosing schedule of the antipsychotic. The primary outcomes were the incidence and duration of delirium.ResultsEighty patients were included in the study. Patients received scheduled quetiapine (35%), PRN haloperidol (55%), and PRN quetiapine (10%). The overall incidence of delirium in patients receiving antipsychotics was 39%. The incidence of delirium was similar between the scheduled quetiapine group, PRN haloperidol and PRN quetiapine groups, at 39%, 50% and 36%, respectively (p=0.79). The scheduled quetiapine group had a longer time to first episode of delirium, but this was not statistically significant (11days vs 4.8days vs 5.6days; p=0.20).ConclusionsThere was no difference in incidence or duration of delirium between quetiapine and haloperidol regimens.Copyright © 2017 Elsevier Inc. All rights reserved.

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