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Delirium - symptom, Treatment of Delirium
Delirium is a state of excitement and mental confusion, with hallucinations and illusions, caused by a disorder of the central nervous system. This could be an injury, a seizure, a drug toxicity of withdrawal, meningitis or encephalitis, or a type of dementia. Delirium affects 10 to 30 percent of hospitalized patients with medical illness; more than 50 percent of persons in certain high-risk populations are affected. It can be defined as a a state of confusion often associated with hallucinations and hyperactivity, in which the patient is inaccessible to normal contact. Delirium is more common in the elderly than in the general population. While it is not a specific disease itself, patients with delirium usually fare worse than those with the same illness who do not have delirium. The delirious person is drowsy, restless, and fearful of imaginary disasters. He may suffer from hallucinations, seeing terrifying imaginary animals or thinking the building is on fire. Maniacal excitement may follow. Although the clinical presentation of delirium differs considerably from patient to patient, there are several characteristic features that help make the diagnosis. It is wise to also check a patients personal and family history for serious psychiatric illness.
Symptoms of Delirium
- decreased awareness of the environment
- confusion or disorientation, especially of time
- memory impairment, especially of recent events
- illusions and misinterpreted stimuli
- increased or decreased activity level
- mood disturbance, possibly including anxiety , euphoria or depression
- language or speech impairment
Treatment - Medications that may be considered for use include:
Beta-blockers if dementia is related to central nervous system lesions.
Serotonin-affecting drugs (lithium, trazodone, buspirone, clonazepam).
Dopamine blockers (such as haloperidol).
Fluoxetine, imipramine may be used to stabilize mood.
Stimulant drugs, may improve mood.