Morteza Talebi Doluee; Zahra Abbasi Shaye; Mahdi Talebi; Abbas Farhadi
Volume 23, Issue 2 , 2021
Abstract
Background: Delirium is a psychiatric syndrome observed among patients with critical psychiatric disorders. Haloperidol is now one of the first-line drugs for the treatment of delirium. However, quetiapine can be considered as an appropriate substitute in patients with a high risk of extrapyramidal symptoms ...
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Background: Delirium is a psychiatric syndrome observed among patients with critical psychiatric disorders. Haloperidol is now one of the first-line drugs for the treatment of delirium. However, quetiapine can be considered as an appropriate substitute in patients with a high risk of extrapyramidal symptoms or long QT syndrome.
Objectives: This study aimed to compare the effectiveness of intramuscular haloperidol and oral quetiapine to control delirium in patients in the emergency department and intensive care unit.
Methods: This randomized clinical trial was performed during 2017-2018 on patients with delirium who were referred to the emergency department and intensive care unit of Imam Reza Hospital (referral center), Mashhad, Iran. Patients were divided into two groups of 100 patients per group through a random allocation technique . In this study, 5 mg of intramuscular haloperidol every 12 hours and 25 mg of oral quetiapine were prescribed daily for the patients in the control and intervention groups, respectively. The delirium severity score of each patient was evaluated before and three days after the intervention through Delirium Rating Scale-Revised-98.
Results: In this study, the mean±SD age of participants was 60.2±14.1 years. The findings indicated that no significant difference was observed between haloperidol (22.7±1.9) and quetiapine (22.7±2.2) groups in terms of the baseline delirium severity score (P=0.95). The mean delirium severity scores of patients in haloperidol and quetiapine groups were 25.6±2.1 and 25.2±2.5, respectively. Based on the obtained results, the difference between the delirium severity scores of both groups was not statistically significant (P=0.24).
Conclusion: Based on the results, oral quetiapine has a similar effect as intramuscular haloperidol and can be used as a substitute to this medicine for controlling the symptoms of patients with delirium.
Yalda Nahidi; Shapour Badiee; Shatila Torabi; Zahra Abbasi Shaye; Fatemeh Nazemian; Azadeh Saki
Volume 20, Issue 10 , 2018, Pages 1-7
Abstract
Background: End-stage renal disease (ESRD) is a worldwide growing public health concern. Hemodialysis (HD) is a treatment op- tion for people experiencing ESRD. Because of limited therapeutic methods due to the vague pathogenesis, the control of pruritus is so difficult. Thus, we decided to carry out ...
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Background: End-stage renal disease (ESRD) is a worldwide growing public health concern. Hemodialysis (HD) is a treatment op- tion for people experiencing ESRD. Because of limited therapeutic methods due to the vague pathogenesis, the control of pruritus is so difficult. Thus, we decided to carry out this study to examine the effect of acupuncture on pruritus. Methods: This multi-centered randomized clinical trial was conducted during 2015 - 2017 in the hemodialysis wards of teaching hospitals in Mashhad, Iran. 30 patients that met the inclusion criteria entered the study by a convenience sampling and were ran- domized into two groups: One group receiving acupuncture intervention and the other receiving sham acupuncture as the control group. We measured the visual analog scale (VAS) score of pruritus before and after the intervention in the two groups. Results: The mean age of the participants was 49.04 ± 14.93 with a minimum age of 23 years and a maximum age of 65 years. 17 (65.40%) patients were male, and nine (34.60%) were female. We had a significant difference between the scores of both groups before and after the intervention, but the difference of the scores was more significant in the intervention group than in the controlgroup (5.94 versus 1.27, respectively). Our study also showed a significant difference between the two groups after the intervention (P value < 0.001). Conclusions: Our findings indicate that acupuncture, as a noninvasive, safe, and easy treatment, can be useful and effective for the management of Hemodialysis patients with pruritus. Identifying the pathophysiology of pruritus and neurobiological mechanism of acupuncture to reduce pruritus will remarkably improve the application of new therapies to decrease itching.
