Delirium : Treatment

Treatment

The goal of treatment is to control or reverse the cause of the symptoms. Treatment depends on the condition causing delirium. Diagnosis and care should take place in a pleasant, comfortable, nonthreatening, physically safe environment. The person may need to stay in the hospital for a short time.

Stopping or changing medications that worsen confusion, or that are not necessary, may improve mental function. Medications that may worsen confusion include:

  • Alcohol and illegal drugs
  • Analgesics
  • Anticholinergics
  • Central nervous system depressants
  • Cimetidine
  • Lidocaine

Disorders that contribute to confusion should be treated. These may include:

  • Heart failure
  • Decreased oxygen (hypoxia)
  • High carbon dioxide levels (hypercapnia)
  • Thyroid disorders
  • Anemia
  • Nutritional disorders
  • Infections
  • Kidney failure
  • Liver failure
  • Psychiatric conditions (such as depression)

Treating medical and mental disorders often greatly improves mental function.

Medications may be needed to control aggressive or agitated behaviors. These are usually started at very low doses and adjusted as needed.

Medications include:

  • Dopamine blockers (haloperidol, olanzapine, risperidone, clozapine)
  • Mood stabilizers (fluoxetine, imipramine, citalopram)
  • Sedating medications (clonazepam or diazepam)
  • Serotonin-affecting drugs (trazodone, buspirone)
  • Thiamine

Some people with delirium may benefit from hearing aids, glasses, or cataract surgery.

Other treatments that may be helpful:

  • Behavior modification to control unacceptable or dangerous behaviors
  • Reality orientation to reduce disorientation

Prognosis (Expectations)

Acute conditions that cause delirium may occur with chronic disorders that cause dementia. Acute brain syndromes may be reversible by treating the cause.

Delirium often lasts only about 1 week, although it may take several weeks for mental function to return to normal levels. Full recovery is common.

Complications

  • Loss of ability to function or care for self
  • Loss of ability to interact
  • Progression to stupor or coma
  • Side effects of medications used to treat the disorder

Calling Your Health Care Provider

Call your health care provider if there is a rapid change in mental status.


Review Date : 2/13/2008
Reviewed By : Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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