METHODS: We retrospectively investigated the records of patients with delirium treated with GBP (71 patients; median age, 81 years; interquartile range, 76-87.5 years; 54.9% males) at a general hospital. We examined duration to delirium improvement, as assessed by the Intensive Care Delirium Screening Checklist (ICDSC) and DSM-5 criteria, as well as adverse events.
RESULTS: The median (interquartile range) GBP dose was 200 mg (150-350 mg) /day. A total of 71.8% and 85.9% of the patients failed to meet the diagnostic criteria for delirium at 2 days and 5 days after initial administration, respectively (p<0.05). In subgroup analysis, patients with a history of epilepsy or cerebrovascular disease responded better to GBP than did those without such histories, suggesting that patients with abnormal/borderline neuronal activity respond to GBP even though they do not exhibit seizures. GBP did not induce extrapyramidal symptoms, cardiac conduction disturbances, hyperglycemia, or epilepsy but caused sleepiness and myoclonus.
CONCLUSIONS: GBP may improve delirium with fewer adverse effects and may be a safe alternative or adjunct treatment for delirium. Dosage adjustment may be necessary to prevent sleepiness.
方法:我们回顾性调查了接受GBP治疗的谵妄患者的记录(71例;中位年龄,81年;四分位数范围,76-87.5岁;男性占54.9%)在综合医院。我们检查了谵妄改善的持续时间,根据重症监护谵妄筛查清单(ICSC)和DSM-5标准评估,以及不良事件。
结果:GBP剂量的中位数(四分位距)为200mg(150-350mg)/天。分别有71.8%和85.9%的患者在初次给药后2天和5天未能达到谵妄的诊断标准,分别为(p<0.05)。在亚组分析中,有癫痫或脑血管疾病病史的患者对GBP的反应比没有癫痫或脑血管疾病病史的患者好。提示具有异常/临界神经元活动的患者对GBP有反应,即使他们没有表现出癫痫发作.GBP没有诱发锥体外系症状,心脏传导紊乱,高血糖症,或癫痫,但引起嗜睡和肌阵挛症。
结论:GBP可以改善谵妄,不良反应较少,可能是谵妄的安全替代或辅助治疗。可能需要调整剂量以防止嗜睡。