A drug combo can minimise agitated delirium in patients with advanced cancers

Treatment with a combination of haloperidol and lorazepam reduced symptoms of agitated delirium, compared with haloperidol alone, according to the study led by researchers at The University of Texas MD Anderson Cancer Center.

David Hui, professor of Palliative, Rehabilitation and Integrative Medicine, said that advanced delirium is common and highly distressing in many patients with advanced cancers receiving palliative care.

"But we've had limited evidence on the use and effectiveness of treatment for this condition," said Hui.

"The RECORD trial offers valuable data and insights that support the use of therapy in the palliative care setting in order to provide patients with greater comfort," he added.

Agitated delirium occurs when a patient's brain function begins to deteriorate as their cancer advances, resulting in many patients beginning to behave aggressively or abnormally.

Although the use of medication in this setting has been debated, these results suggest tailored combination treatments can significantly improve symptoms for patients at the end of life.

In the study, patients that received the combination of haloperidol and lorazepam experienced a significant decrease in agitated delirium when measured at 24 hours with a standard scoring tool.

In that same time frame, this group needed no more than two rescue doses, or additional medication provided as needed.

The team also observed a significant decrease in agitated delirium in patients treated with lorazepam alone, but these patients required more rescue doses.

The placebo group saw very little reduction in delirium, and, in some scenarios, patients needed as many as five rescue doses.

"By proactively personalising treatment of this distressing symptom, we are providing caregivers, families and patients an opportunity for meaningful connection in the time they have remaining," Hui said.