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Delirium : Haloperidol Lactate Vs. Risperidone

Definition

Delirium (acute confusional state) is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior. It typically involves other cognitive deficits, changes in arousal (hyperactive, hypoactive, or mixed), perceptual deficits, altered sleep-wake cycle, and psychotic features such as hallucinations and delusions. It is often caused by a disease process 'outside' the brain, such as common forms of infection (UTI, pneumonia) or by drug effects, particularly anticholinergic or other CNS depressants (benzodiazapenes and opioids). It can also be caused by virtually any primary disease of the central nervous system. Though hallucinations and delusions are sometimes present, these are not required for the diagnosis, and the symptoms of delirium are clinically distinct from those induced by psychosis or hallucinogens (with the exception of deliriants.) Although commonly referred to as a primary disorder of attention, other core cognitive processes are disrupted, particularly working memory and virtually all aspects of executive functions (planning and organization of behavior). Although it is commonly regarded as reversible, induction of delirium in patients with dementia due to Alzheimer's disease appears to accelerate cognitive decline, suggesting that efforts to prevent and minimize the induction of confusional states in the elderly should be given high priority. Unfortunately, many instances of confusional state (delirium) are iatrogenic (caused by medicines or hospital-borne pathogens/bacteria or surgeries and anesthesia).

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