Comparing Haloperidol and Olanzapine in Treating Terminal Delirium

Summary

As patients with terminal illness enter the dying phase, they may experience symptoms of restlessness, agitation, or cognitive disturbance, known as terminal delirium. In community care, pharmacological therapies are utilized to manage the syndrome, the most commonly used being neuroleptics haloperidol and olanzapine. However, there is currently a dearth of studies on the efficacy and safety between haloperidol and olanzapine in the community palliative care setting; existing studies involve non-terminal patients in the hospital suffering from acute delirium. To fill this gap, an open-label randomized clinical trial is proposed to compare the effects of haloperidol and olanzapine in the management of terminal delirium in home hospice patients who are imminently dying. Key outcome measures are the reduction of delirium symptoms and the reduction of agitation. Secondary outcome is comparing the adverse effect burden on patients.

Timeline

Start

2021-09-01

Primary completion

2024-05

Completion

2024-05

Publications

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• Results Jain R, Arun P, Sidana A, Sachdev A. Comparison of efficacy of haloperidol and olanzapine in the treatment of delirium. Indian J Psychiatry. 2017 Oct-Dec;59(4):451-456. doi: 10.4103/psychiatry.IndianJPsychiatry_59_17.
• Lyu XJ, Kan AD, Chong PH, Lin K, Koh YH, Yeo ZZ. An open-label clinical trial of oral transmucosal haloperidol and oral transmucosal olanzapine in the treatment of terminal delirium at home. Trials. 2022 Apr 14;23(1):311. doi: 10.1186/s13063-022-06238-4.

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Indications