Objective: To review the current state of pharmacological treatment of delirium in the pediatric population and to derive a treatment protocol from our review.
Method: Medline-assisted search of the literature. Articles pertaining to the pharmacological treatment of delirium in children and adolescents were reviewed. Due to the paucity of articles, studies of treatment guidelines for delirium in the adult population were reviewed. Also presented for reference, are studies of optimal dosing regimens of psychotropic agents potentially useful in treating pediatric delirium. Our protocol is extrapolated from previously established guidelines for adult treatment meshed with the current knowledge presented in the literature pertaining to children and adolescents.
Results:Review revealed only one retrospective study evaluating the pharmacological treatment of delirium in children and adolescents. One anecdotal report of risperidone successfully treating delirium is presented. Intravenous haloperidol is the mainstay of pharmacological treatment in medically ill adults and haloperidol has a long history of safety and efficacy in children and adolescents.
Conclusion: Use of intravenous haloperidol with titration to an efficacious dose would be the first line approach to treat symptoms of delirium in the pediatric population. However the lack of data and systematic analysis in the literature demonstrates an acute need for structured research in this area.
Lavid, Nathan M.D. and Budner, Lawrence J. M.D., F.A.A.C.A.P.
"Review of the Pharmacological Treatment of Delirium in the Pediatric Population with Accompanying Protocol,"
Jefferson Journal of Psychiatry:
1, Article 3.
Available at: http://jdc.jefferson.edu/jeffjpsychiatry/vol15/iss1/3