Psychiatry - October 2008 - (Page 29)

[REVIEW] Delirium and Antipsychotics: A Systematic Review of Epidemiology and Somatic Treatment Options by JOSEPH D. MARKOWITZ, MD, and MEERA NARASIMHAN, MD Dr. Markowitz is Attending Psychiatrist at the James A. Haley Veterans Administration Hospital and Assistant Professor of Psychiatry at the University of South Florida, Tampa, Florida; and Dr. Narasimhan is Professor of Neuropsychiatry and Behavioral Sciences at the University of South Carolina, Columbia, South Carolina. Psychiatry (Edgemont) 2008;5(10):29–36 ABSTRACT Delirium is a very common medical condition encountered throughout the world and, undoubtedly, is one of the most frequent reasons psychiatrists are consulted by primary care physicians. Recognizing delirium and treating the underlying medical cause are the first steps in the management of this potentially fatal syndrome. The selection of an appropriate medication to target the perceptual, behavioral, and cognitive abnormalities is crucial. In addition to several of the older, typical antipsychotics, which have been found to be effective for the treatment of delirium, some of the newer, atypical antipsychotic agents have been demonstrated to be efficacious. This paper will review both the typical and atypical antipsychotics with the best evidence for efficacy and safety in the treatment of delirium. Finally, environmental treatments are discussed to present the full armamentarium of therapeutic options available to the practicing clinician. INTRODUCTION Delirium is best described as a disturbance of consciousness with reduced attention, changes in cognition, and perceptual disturbances. Delirium is more common than may be predicted as 10 to 15 percent of medically ill FINANCIAL DISCLOSURE: The author has no financial conflicts of interest with the material presented in this review. ADDRESS CORRESPONDENCE TO: Joseph D. Markowitz, MD, 13000 Bruce B. Downs Blvd., Attention: Mental Health and Behavioral Science, Tampa, FL 33612; Phone: (813) 631-7135 ext.4384; E-mail: Joseph.Markowitz@va.gov KEY WORDS: delirium, antipsychotics, epidemiology, somatic treatment [OCTOBER] Psychiatry 2008 29

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Psychiatry - October 2008 Editor’s Message Editorial Advisory Board Contents Psych Rx Treatment of Migraine and the Role of Psychiatric Medications Play Therapy: A Case-based Example of a Nondirective Approach Delirium and Antipsychotics: A Systematic Review of Epidemiologyand Somatic Treatment Options Severely Mood-disordered Youth Respond Less Well to Treatment in a Community Clinic than Youth with Bipolar Disorder Beyond Informed Consent: The Ethics of Informing, Anticipating, and Warning Asthma: Wheezing, Woes, and Worries Classified Advertising Journal Watch Information for Authors

Psychiatry - October 2008

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