Chlorpromazine's Potential Role in Palliating Distressing Symptoms Associated with Hyperactive Delirium in Patients at End of Life.
Casey M TiefenthalerJeremy M HirstKyle P EdmondsRabia S AtayeePublished in: Journal of palliative medicine (2023)
Background: The hyperactive subtype of delirium is characterized by agitation, restlessness, delusions, and/or hallucinations, which commonly present near end of life (EoL). Symptom relief often requires the use of medications, such as chlorpromazine (CPZ), to reduce patient distress by inducing proportional sedation. Objective: The purpose of this study was to evaluate CPZ's potential role in managing the distress of hyperactive delirium in patients receiving EoL care. Methods: A retrospective observational study among hospitalized patients with advanced cancer at EoL between January 2020 to December 2021. Results: Sustained improvement in symptoms of delirium was seen in 80% of patients as identified in the palliative psychiatrist's progress notes. Meanwhile, 75% of patient's improvement was reported in nursing-driven Delirium Observation Screening Scale. Conclusion: This study elucidates that at doses of ∼100 mg/day, CPZ is potentially an effective medication for patients with advanced cancer, experiencing hyperactive delirium in their final week of life.
Keyphrases
- advanced cancer
- palliative care
- cardiac surgery
- hip fracture
- healthcare
- end stage renal disease
- acute kidney injury
- ejection fraction
- mental health
- newly diagnosed
- physical activity
- quality improvement
- randomized controlled trial
- emergency department
- intensive care unit
- sleep quality
- peritoneal dialysis
- pain management
- depressive symptoms
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation
- patient reported outcomes