Abstract
BackgroundDelirium in older adults is a common and serious acute neuropsychiatric syndrome, with core features of inattention and global cognitive impairment. Although antipsychotic drugs are the medications most frequently used to treat this syndrome, these drugs are associated with a variety of adverse events, including sedation, extrapyramidal side effects, and cardiac arrhythmias.MethodsWe report on two cases in which monotherapy of the selective serotonin reuptake inhibitor and sigma-1 receptor agonist fluvoxamine was effective in ameliorating the delirium of patients with Alzheimer's disease.ResultsDelirium Rating Scale (DRS) scores in the two patients with Alzheimer's disease decreased after fluvoxamine monotherapy.ConclusionDoctors should consider that fluvoxamine could be an alternative approach in treating delirium in patients with Alzheimer's disease because of the risk of extrapyramidal side effects by antipsychotic drugs.
Highlights
Delirium in older adults is a common and serious acute neuropsychiatric syndrome, with core features of inattention and global cognitive impairment
Antipsychotic drugs are associated with a variety of adverse events, including sedation, extrapyramidal side effects, and cardiac arrhythmias
The pathophysiology of delirium is not fully understood, current evidence suggests that drug toxicity, inflammation and acute stress responses can all contribute to a disruption of neurotransmission and, to the development of delirium [1]
Summary
We report on two cases in which monotherapy of the selective serotonin reuptake inhibitor and sigma receptor agonist fluvoxamine was effective in ameliorating the delirium of patients with Alzheimer’s disease. Results: Delirium Rating Scale (DRS) scores in the two patients with Alzheimer’s disease decreased after fluvoxamine monotherapy
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