Efficacy and safety of aripiprazole in the treatment of delirium.

Abstract

Delirium is a psychosis with disorder of consciousness and it's caused by acute brain disfunction in the course of e.g. severe somatic condition, intoxication or withdrawal syndrome. Delirium management is based on the treatment of the state that caused disturbance in central nervous system. Severe delirium syndromes such as agitation, disorganized behavior or hallucinations require additional pharmacological treatment with antypsychotics. Aripiprazole is one of second generation antypsychotics (SGA), that is used in treatment of schizophrenia, bipolar disorder and Tourette syndrome, but also off-label in delirium. A systematic review of databases was carried out and results were limited to case reports, clinical trials and randomized controlled trials. The results of literature review suggest that aripiprazole can be useful in treatment of delirium symptomes. There is evidence, aripirazole has efficacy comparable to haloperidol and other SGA. Aripirazole can be a better option in particular groups of patients due to it's safer cardiological and metabolic profile and better tolerance of treatment. However, data from clinical findings are still insufficient to recommend a routine use of aripirazole in the treatment of delirium. Therefore, further investigations are necessary to work out new strategy of managing delirium syndrome.