MedPath

Rivastigmine for Intensive Care Unit (ICU) Delirium

Phase 4
Terminated
Conditions
Delirium
Interventions
Drug: Placebo
Registration Number
NCT00704301
Lead Sponsor
UMC Utrecht
Brief Summary

Delirium in Intensive Care (IC) patients is a frequent disorder. The aim of this study is to investigate whether treatment of delirium in the ICU with rivastigmine added to haloperidol shortens the duration of delirium in comparison to placebo added to the treatment with haloperidol.

Detailed Description

Objective: To study whether rivastigmine added to treatment with haloperidol shortens the duration of delirium in ICU patients and reduces costs.

Study design: Multicentre, double-blind, randomized controlled trial. Study population: Consecutive adult ICU patients with delirium according to the CAM-ICU.

Intervention: Increasing dosage of rivastigmine or placebo as add-on medication.

Primary study parameters: Duration of delirium. Secondary study parameters: Delirium severity, length of ICU and hospital stay, functional status and mortality after 3 months.

Sample size: 440 patients will be included. Economic evaluation: includes a comparison of direct and indirect medical costs.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: Burden: questionnaires (duration: 30 minutes). Risk: possible exposure to drug not indicated for the disorder. Benefit: possible treatment with according to experts possible beneficial drug. Consideration: The investigators of this study believe that the burden and risk do not exceed the expected benefit.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
104
Inclusion Criteria
  • 18 years or older
  • Positive CAM-ICU
Exclusion Criteria
  • Known allergy to rivastigmine
  • Unable to receive enteric medication
  • Pregnant or lactating
  • Renal replacement therapy
  • Hepatic encephalopathy
  • Second or third degree atrioventricular block
  • Uncertainty about diagnosis delirium and no confirmation by neurologist, psychiatrist or geriatrician
  • Parkinson's disease.
  • Lewy body dementia.
  • ECG QT interval above 500 msec.
  • No informed consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2PlaceboHaloperidol: aged 70 years or less: 1 mg haloperidol three times a day i.v. older than 70 years: 0,5 mg haloperidol three times a day i.v. Placebo: 2 times a day
1RivastigmineHaloperidol: aged 70 years or less: 1 mg haloperidol three times a day i.v. older than 70 years: 0,5 mg haloperidol three times a day i.v. Rivastigmine: two times 1,5 mg a day; The dosage will be increased every three days with 3 mg a day, until the CAM-ICU is negative or until the occurrence of presumed severe adverse effects or until a maximum of 12 mg a day.
Primary Outcome Measures
NameTimeMethod
Duration of delirium3 months
Secondary Outcome Measures
NameTimeMethod
Severity of delirium3 months
Use of physical restraints3 months
Use of escape medication (i.c. Haloperidol or benzodiazepines)3 months
Number of accidental removed catheters3 months
Length of ICU stay3 months
Length of in-hospital stay3 months
Cognitive outcomes3 months
Activity of daily living3 months
Healthcare costs3 months
Frequency and distribution of side effects3 months

Trial Locations

Locations (6)

Medical Center Leeuwarden

🇳🇱

Leeuwarden, Friesland, Netherlands

Gelre Hospitals; lukas site

🇳🇱

Apeldoorn, Gelderland, Netherlands

Erasmus Medical Center

🇳🇱

Rotterdam, Zuid-Holland, Netherlands

Diakonessenhuis

🇳🇱

Utrecht, Netherlands

Medical Center Alkmaar

🇳🇱

Alkmaar, Noord-Holland, Netherlands

University Medical Center Utrecht

🇳🇱

Utrecht, Netherlands

© Copyright 2025. All Rights Reserved by MedPath