Sigma-1 receptor agonist fluvoxamine for delirium in intensive care units report of five cases 英文参考文献.docVIP

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Sigma-1 receptor agonist fluvoxamine for delirium in intensive care units report of five cases 英文参考文献.doc

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Sigma-1 receptor agonist fluvoxamine for delirium in intensive care units report of five cases 英文参考文献

Furuse and Hashimoto Annals of General Psychiatry 2010, 9:18 /content/9/1/18 CASE REPORT Open Access Sigma-1 receptor agonist fluvoxamine for delirium Case report in intensive care units: report of five cases Tsutomu Furuse*1 and Kenji Hashimoto2 Abstract Background: Delirium is a highly prevalent disorder among older patients in intensive care units (ICUs). Although antipsychotic drugs are the medications most frequently used to treat this syndrome, these drugs are associated with a variety of adverse events, including sedation, extrapyramidal side effects, and cardiac arrhythmias. Drug treatment for delirium requires careful consideration of the balance between the effective management of symptoms and potential adverse effects. Methods: We report on five Japanese men (an 84 year old (acute aortic dissociation: Stanford type A), a 55 year old (traumatic subarachnoid hemorrhage and brain contusion), a 76 year old (sepsis by pyelonephritis), an 85 year old (cerebral infarction), and an 86 year old (pulmonary emphysema and severe pneumonia)) in which the selective serotonin reuptake inhibitor and sigma-1 receptor agonist fluvoxamine was effective in ameliorating the delirium of the patients. Results: Delirium Rating Scale (DRS) scores in these five patients dramatically decreased after treatment with fluvoxamine. Conclusion: Doctors should consider fluvoxamine as an alternative approach to treating delirium in ICU patients in order to avoid the risk of side effects and increased mortality from antipsychotic drugs. Background Delirium is a common complication in intensive care Additionally, there is an association between antipsy- dry mouth, constipation, and urinary retention [1-4]. units (ICUs) [1-3]. Acute syndrome caused by a distur- bance of the cognitive processes in the brain is associated with poor short-term outcomes and may result in adverse sequelae years after ICU discharge [1-3]. Although the pathophysiology