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July 14, 2004

Pharmacological Treatment of Delirium in the Intensive Care Unit

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;292(2):168. doi:10.1001/jama.292.2.168-a

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.35 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.