Abstract
Objective: H<sub>2</sub> blockers have been reported to be responsible for drug-induced delirium. We compared the incidence of delirium between two groups of patients who were treated with H<sub>2</sub> blockers (H<sub>2</sub> group) or proton pump inhibitors (PPI group) for anastomotic ulcer prevention following surgical treatment of esophageal cancer. Method: The incidence and severity of delirium were retrospectively compared in patients of the H<sub>2</sub> group (30 cases; age, 65.2 ± 8.1 years) and the PPI group (30 cases; 65.2 ± 6.5 years). The diagnosis of delirium was based on the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision. Delirium severity was rated on the Delirium Rating Scale (DRS). Results: The incidence of delirium was significantly lower in the PPI group than in the H<sub>2</sub> group (p = 0.047). In the 11 patients from the H<sub>2</sub> group who developed delirium, discontinuation of H<sub>2</sub> blockers resulted in a significant reduction in the DRS score (p = 0.009). In three patients for whom H<sub>2</sub> blockers were discontinued, DRS scores decreased by 50% or more three days after discontinuation compared to the prediscontinuation score. Conclusions: These results suggested that switching antiulcer drugs from H<sub>2</sub> blockers to PPIs reduced delirium and thus provided an appropriate coping method for drug-induced delirium from antiulcer drugs.
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