Risperidone versus olanzapine for the treatment of delirium.

OBJECTIVE: This study compared the effectiveness of risperidone and olanzapine in the treatment of delirium.

METHODS: This was a 7-day, randomized, comparative clinical trial of risperidone and olanzapine in patients with delirium. The primary outcome measure was the Delirium Rating Scale-Revised-98 (DRS-R-98).

RESULTS: We enrolled 32 subjects (median age, 70 years). Significant within-group improvements in the DRS-R-98 scores over time were observed at every time point in both treatment groups; however, differences in the change of the DRS-R-98 score from baseline were not significant between the treatment groups. On the first day after drug treatment, there was a trend toward greater improvement in the DRS-R-98 score in the olanzapine group compared with the risperidone group, but it did not reach statistical significance (p = 0.076). The response rates did not differ significantly between the two groups (risperidone group: 64.7%, olanzapine group: 73.3%). However, the response to risperidone was significantly poorer in patients >or=70 years of age compared with those aged <70 years. There was no significant difference in the safety profiles, including extrapyramidal symptoms (EPSs), between the two groups.

CONCLUSION: Risperidone and olanzapine were equally effective in reducing delirium symptoms. The response to risperidone was poorer in the older age group.