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Drug 'does not decrease delirium duration'

The cholinesterase inhibiting drug rivastigmine (Exelon) does not decrease the duration of delirium in critically ill patients and could increase mortality, warn Dutch researchers.

They randomised 104 patients diagnosed with delirium to receive an increasing twice daily dose of rivastigmine or placebo, as an adjunct to usual care based on haloperidol. 

The trial was halted early because mortality in the rivastigmine group was higher than in the placebo group - 12 patients died compared with 4 controls.

Median duration of delirium was 5 days in the rivastigmine group, compared with 3 days in the placebo group.

The authors said: “We do not recommend treatment of delirium with rivastigmine for patients in intensive care.”

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