Chlorpromazine's Potential Role in Palliating Distressing Symptoms Associated with Hyperactive Delirium in Patients at End of Life

Background: The hyperactive subtype of delirium is characterized by agitation, restlessness, delusions, and/or hallucinations, which commonly present near end of life (EoL). Symptom relief often requires the use of medications, such as chlorpromazine (CPZ), to reduce patient distress by inducing proportional sedation.Objective: The purpose of this study was to evaluate CPZ's potential role in managing the distress of hyperactive delirium in patients receiving EoL care.Methods: A retrospective observational study among hospitalized patients with advanced cancer at EoL between January 2020 to December 2021.Results: Sustained improvement in symptoms of delirium was seen in 80% of patients as identified in the palliative psychiatrist's progress notes. Meanwhile, 75% of patient's improvement was reported in nursing-driven Delirium Observation Screening Scale.Conclusion: This study elucidates that at doses of similar to 100 mg/day, CPZ is potentially an effective medication for patients with advanced cancer, experiencing hyperactive delirium in their final week of life.

Automated summary

This study found that Chlorpromazine (CPZ) can effectively relieve symptoms of hyperactive delirium in end-of-life care. 80% of patients showed improvement in symptoms according to the progress notes by the palliative psychiatrist, while 75% of patients reported improvement based on the nursing-driven Delirium Observation Screening Scale.