Evidence-Based Reviews

Clearing up confusion

Current Psychiatry. 2015 March;14(3):18-21, 28-31

References

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Yet, some of the interventions, such as the use of statins for hyperlipidemia, remain controversial, with some studies suggesting that they help cognition,^22,23 and others showing no association.²⁴ The researchers caution that further research is warranted before costly dementia prevention trials with statins are undertaken. It does not appear that there are current MEND-type research projects in delirium but it’s to be hoped that we will see these in the future.

In the case of Ms. T, the cause of delirium vs mild NCD was thought to be multifactorial. Discontinuing Armour Thyroid and metformin—symptoms of hypoglycemia emerged as a leading concern—were simple adjustments that led to resolution of the most concerning elements of her confusion. She continued her other psychotropics, although there might be mild residual cognitive issues that warrant close observation.

Related Resources
• Lin JS, O’Connor E, Rossum RC, et al. Screening for cognitive impairment in older adults: an evidence update for the U.S. Preventive Services Task Force. Rockville, MD: Agency for Healthcare Research and Quality (US); 2013.
• Grover S, Kate N. Assessment scales for delirium: a review. World J Psychiatry. 2012;2(4):58-70.

Drug Brand Names
Atorvastatin • Lipitor Lithium • Eskalith, Lithobid
Donepezil • Aricept Lorazepam • Ativan
Escitalopram • Lexapro Memantine • Namenda
Flumazenil • Romazicon Metformin • Glucophage
Galantamine • Razadyne Naloxone • Narcan
Glipizide • Glucotrol Physostigmine • Antilirium
Haloperidol • Haldol Quetiapine • Seroquel
Levothyroxine • Levoxyl, Synthroid Rivastigmine • Exelon
Lithium • Eskalith, Lithobid Valproic acid • Depakene

Disclosure
Dr. Raj is a speaker for Actavis Pharmaceuticals, AstraZeneca, and Merck.

Clearing up confusion

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