lurasidone-hydrochloride and Critical-Illness

To evaluate the efficacy and safety of lurasidone compared with quetiapine for treatment of delirium in critically ill patients.. Prospective, observational cohort study.. Single-center community teaching hospital.. Forty adult intensive care unit (ICU) patients with delirium (Confusion Assessment Method in the ICU positive), tolerating enteral nutrition, and without active alcohol withdrawal or prior use of atypical antipsychotics.. Patients were treated at the discretion of the prescriber with either lurasidone or quetiapine for delirium. Dose escalation and/or discontinuation were determined at the discretion of individual providers.. Baseline characteristics differed with a higher severity of illness in patients in the quetiapine group (n = 20) and a higher baseline QTc interval in the lurasidone group (n = 20). No significant difference was seen in the time to delirium resolution (3.2 vs 3.4 days), average daily haloperidol requirements (5.7 vs 6.9 mg), hospital length of stay (LOS; 23.6 vs 27.9 days), or ICU LOS (12.1 vs 14.2 days). Lurasidone was associated with fewer ventilator support days (4.0 [interquartile range, IQR: 2.3-6.8] days vs 7 [IQR: 4.0-9.8;. Lurasidone for the treatment of delirium in critically ill patients did not differ in the time to delirium resolution when compared to quetiapine. Additionally, the incidence of QTc prolongation between agents does not appear to be different. Future randomized trials should evaluate dose escalation schemes and a larger proportion of patients to evaluate differences in mortality, efficacy, and life-threatening arrhythmias associated with atypical antipsychotic use.

Topics: Aged; Antipsychotic Agents; Critical Care Outcomes; Critical Illness; Delirium; Female; Humans; Intensive Care Units; Lurasidone Hydrochloride; Male; Middle Aged; Prospective Studies; Quetiapine Fumarate; Severity of Illness Index; Treatment Outcome

Topics: Antipsychotic Agents; Critical Illness; Delirium; Humans; Lurasidone Hydrochloride; Quetiapine Fumarate

Topics: Antipsychotic Agents; Critical Illness; Humans; Lurasidone Hydrochloride; Quetiapine Fumarate