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Báo cáo y học: "Sigma-1 receptor agonist fluvoxamine for delirium in intensive care units: report of five cases"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Sigma-1 receptor agonist fluvoxamine for delirium in intensive care units: report of five cases. | Furuse and Hashimoto Annals of General Psychiatry 2010 9 18 http www.annals-general-psychiatry.eom content 9 1 18 ANNALS OF GENERAL PSYCHIATRY CASE REPORT Open Access Sigma-1 receptor agonist fluvoxamine for delirium 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 units ICUs 1-3 . Acute syndrome caused by a disturbance 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 of delirium is not fully understood accumulating evidence suggests that acute oxidative stress responses and inflammation can all .