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posted by chromas on Monday October 22 2018, @11:32PM   Printer-friendly
from the Syrophenikan dept.

Antipsychotic Drugs Don't Ease ICU Delirium Or Dementia

Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine.

[...] "In some surveys up to 70 percent of patients [in the ICU] get these antipsychotics," says Dr. E. Wesley "Wes" Ely, an intensive care specialist at Vanderbilt University Medical Center. They're prescribed by "very good doctors at extremely good medical centers," he says. "Millions of people worldwide are getting these drugs to treat their delirium." [...] Patients with delirium are often confused and incoherent and sometimes can suffer hallucinations. This condition can lead to long-term cognitive problems, including a form of dementia.

[...] Ely and colleagues at 16 U.S. medical centers decided to put antipsychotic drugs to a rigorous test. They divided nearly 600 patients who were suffering from delirium into three groups. One group got the powerful antipsychotic haloperidol. A second group got ziprasidone, which is a related medication from a class of drugs called "atypical antipsychotics." A third group got a placebo.

"The three groups did exactly the same," Ely says. There was no change in the duration of delirium, or the number of coma-free days. "They stayed in the ICU the same amount of time. They stayed on the mechanical ventilator the same amount of time. They didn't get out of the hospital any sooner." "There's not a shred of evidence in this entire investigation that this aggressive approach to treating delirium with antipsychotics, which is commonplace and usual care, did anything for the patients," he concludes.

Also at Vanderbilt University Medical Center.

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness (open, DOI: 10.1056/NEJMoa1808217) (DX)


Original Submission

 
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  • (Score: 3, Funny) by Anonymous Coward on Monday October 22 2018, @11:53PM (3 children)

    by Anonymous Coward on Monday October 22 2018, @11:53PM (#752239)

    Let's keep in mind that the study is biased.
    There was no consultation with the big pharma and, indeed, the industry lob..., err, professional bodies. As such, the study is based only on their opinion and it's terrible, terrible biased.

    Since this is not the first such biased study, let us reiterate one negative impact: in the absence of such consultation, the industry's point of view is eschewed and the participation of the industry in MAGA seriously hampered.
    If the executive branch does not want to see these negative aspects, it should act towards the creation of a legislative framework in which such rogue science studies need to be validated by the industry's professional bodies before publishing.

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  • (Score: 0) by Anonymous Coward on Tuesday October 23 2018, @12:10AM

    by Anonymous Coward on Tuesday October 23 2018, @12:10AM (#752244)

    So true. Those opinionated bastards doing studies that validate their opinions. What bullshit, only 600 patients, with multiple drugs and a placebo control group. All with indistinguishable results because they probably did it blind. Now I tell you how it's supposed to be done: write your study conclusion first, publish, then shred all the results that didn't validate the conclusion. Double blind experimentation is flawed to the core, why have blind people do something that could clearly be done so much better by someone with 20/20 vision? A blind person is likely to trip over and drop the bottle of pills, or accidentally give the pills to the wrong patient because they couldn't read the name on the chart.

    If these kinds of dodgy blind studies continue, I'll have to start looking at other unscrupulous corporate industries to invest.

  • (Score: 0) by Anonymous Coward on Tuesday October 23 2018, @01:32PM

    by Anonymous Coward on Tuesday October 23 2018, @01:32PM (#752461)

    Meta-analyses have shown that psychiatric studies sponsored by pharmaceutical companies are several times more likely to report positive results, and if a drug company employee is involved the effect is even larger.
    -- Controversy about drug marketing and lobbying [wikipedia.org]

    This is a big problem, apparently especially in psychiatry.

  • (Score: 2) by driverless on Wednesday October 24 2018, @05:50AM

    by driverless (4770) on Wednesday October 24 2018, @05:50AM (#752814)

    It's biased, but in a different way than you think. Haloperidol is used to treat schizophrenia and Tourette’s Disorder. Use of intravenous haloperidol to treat acutely agitated patients is an unapproved, off-label use. So what the study is saying is that using this particular medication to treat something it's not intended for treating doesn't work, which isn't terribly surprising.

    It's not the shock, horror story people want it to be. Someone, somewhere, decided to use haloperidol in an unapproved, off-label manner. Somehow, this became adopted as common practice (it's not done here, a non-US country, so I don't know what the story behind it was). What the study is saying is that this off-label use doesn't work, so stop doing it.