Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: In their article on delirium
in the intensive care unit (ICU), Dr Ely and colleagues1 recommended
the use of haloperidol as a "procognitive" medication. Although conventional
antipsychotic agents, such as haloperidol, have long been used to manage delirium,
newer atypical antipsychotic agents may be a better choice, as they cause
fewer extrapyramidal symptoms and may be more effective in improving cognition
among patients with schizophrenia2 and delirium.3- 5 Ely et al stated
that pharmacological interventions in delirium involving medications such
as haloperidol need to be tested in future research. However, it may be more
important to conduct controlled, double-blind studies of second-generation
antipsychotic agents, as these agents may be the preferred medication and
are in common clinical use.
Frankenburg FR. Pharmacological Treatment of Delirium in the Intensive Care Unit. JAMA. 2004;292(2):168. doi:10.1001/jama.292.2.168-a