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“Remarkable” study shows antipsychotics to treat delirium in palliative care do more harm than good
January 6, 2017
A randomized controlled trial found that two antipsychotic drugs commonly used to manage delirium in patients receiving palliative care actually make the symptoms worse. Delirium is a mental disorder with symptoms including hallucinations, confusion and inappropriate behaviour. It is common in palliative care units, especially for patients near the end of their lives. Antipsychotic drugs like risperidone and haloperidol are often given to treat some of these symptoms. Dr.
Peter Lawlor
co-authored a trial published in
JAMA Internal Medicine
that gave 247 patients with delirium from 11 Australian palliative care centres oral doses of risperidone, haloperidol or a placebo for three days. The team found that patients given the antipsychotics had worse delirium symptoms and were 1.5 times more likely to die compared to patients given a placebo. The authors recommend that antipsychotics not be used to treat palliative care patients with mild or moderate delirium. An accompanying
commentary
calls the study “remarkable” and hopes the findings will be immediately translated into practice. Dr. Lawlor is a clinician investigator at The Ottawa Hospital and the Bruyère Research Institute, as well as a palliative care physician at Bruyère Continuing Care and an associate professor at the University of Ottawa.
Co-authors:
Meera R. Agar, PhD; Peter G. Lawlor, MB; Stephen Quinn, PhD; Brian Draper, MD; Gideon A. Caplan, MBBS;Debra Rowett, BPharm; Christine Sanderson, MPH; Janet Hardy, MD; Brian Le, MBBS; Simon Eckermann, PhD;Nicola McCaffrey, PhD; Linda Devilee, MBus; Belinda Fazekas, BN; Mark Hill, PhD; David C Currow, PhD
Funding:
The Australian Government’s Department of Health under the National Palliative Care Strategy, National Health and Medical Research Council, Australia
The Ottawa Hospital: Inspired by research. Driven by compassion
The Ottawa Hospital is one of Canada’s largest learning and research hospitals with over 1,100 beds, approximately 12,000 staff and an annual budget of over $1.2 billion. Our focus on research and learning helps us develop new and innovative ways to treat patients and improve care. As a multi-campus hospital, affiliated with the University of Ottawa, we deliver specialized care to the Eastern Ontario region, but our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care. See www.ohri.ca for more information about research at The Ottawa Hospital.
University of Ottawa: —A crossroads of cultures and ideas
The University of Ottawa is home to over 50,000 students, faculty and staff, who live, work and study in both French and English. Our campus is a crossroads of cultures and ideas, where bold minds come together to inspire game-changing ideas. We are one of Canada’s top 10 research universities—our professors and researchers explore new approaches to today’s challenges. One of a handful of Canadian universities ranked among the top 200 in the world, we attract exceptional thinkers and welcome diverse perspectives from across the globe. www.uottawa.ca
For further information, please contact
Amelia Buchanan
Senior Communication Specialist
Ottawa Hospital Research Institute
Office: 613-798-5555 x 73687
Cell: 613-297-8315
ambuchanan@ohri.ca