Delirium in general practice

Indian Journal of Medical Research

Volumn 131, Issue 3, 2010, Pages 387-398

  Mattoo, Surendra Kumar ^a   Grover, Sandeep ^a   Gupta, Nitin ^a,b  

^a POSTGRADUATE INSTITUTE OF MEDICAL EDUCATION AND RESEARCH   (India)

^b Staffordshire and Stoke on Trent Partnership NHS Trust   (United Kingdom)

Author keywords

Delirium; Disorientation; Memory impairment; Mood changes; Prevalence

Indexed keywords

ATYPICAL ANTIPSYCHOTIC AGENT; BENZODIAZEPINE DERIVATIVE; DONEPEZIL; HALOPERIDOL; LORAZEPAM; NEUROLEPTIC AGENT; OLANZAPINE; QUETIAPINE; RISPERIDONE;

CLINICAL FEATURE; CLINICAL TRIAL; DELIRIUM; DEMENTIA; DEPRESSION; DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS; DIAGNOSTIC VALUE; DIFFERENTIAL DIAGNOSIS; DISEASE CLASSIFICATION; DRUG BIOAVAILABILITY; DRUG DOSE TITRATION; DRUG EFFICACY; DRUG TOLERABILITY; EXTRAPYRAMIDAL SYNDROME; HEART ARRHYTHMIA; HUMAN; INCIDENCE; INDIA; INTERNATIONAL CLASSIFICATION OF DISEASES; MENTAL HEALTH; MINI MENTAL STATE EXAMINATION; MUSIC THERAPY; NEUROPSYCHOLOGICAL TEST; PATHOGENESIS; PREVALENCE; PRIMARY PREVENTION; PROGNOSIS; PSYCHOSIS; QT PROLONGATION; REVIEW; RISK FACTOR; SCHIZOPHRENIA; SIDE EFFECT; UNSPECIFIED SIDE EFFECT;

EID: 77949720324     PISSN: 09715916     EISSN: 09715916     Source Type: Journal    
DOI: None     Document Type: Review

References (124)

1. Adamis D, Treloar A, Martin FC, Macdonald AJD. A brief review of the history of delirium as a mental disorder. Hist Psychiatry 2007 18: 459-69.
2. Lindesay J. The concept of delirium. Dement Geriatr Cogn Disord 1999 10: 310-4.
3. Trzepacz PT, Meagher DJ. Delirium. In: Levenson JL, editor. Textbook of psychosomatic medicine. Washington DC: American Psychiatric Association 2005. p. 91-130
4. British Geriatrics Society & Royal College of Physicians. Guidelines for the prevention, diagnosis, and management of delirium in older people. London: Royal College of Physicians of London 2006.
5. Siddiqi N, House AO, Holmes JD. Occurrence and outcome of delirium in medical inpatients: a systematic literature review. Age Ageing 2006 35: 350-64.
6. Folstein MF, Bassett SS, Romanoski AJ. The epidemiology of delirium in the community: the Eastern Baltimore Mental Health Survey. Int Psychogeriatr 1991 3: 169-76
7. Fann JR. The epidemiology of delirium: a review of studies and methodological issues. Semin Clin Neuropsychiatry 2000 5: 64-74.
8. th ed. Washington DC: American Psychiatric Press 2007. p. 445-517.
9. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, ed 1, Text Revision (DSM-I). Washington DC: American Psychiatric Association 1952
10. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, ed 2, Revised (DSM-II). Washington DC: American Psychiatric Association 1968.
11. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, ed 3, (DSM-III). Washington DC: American Psychiatric Association 1980
12. nd ed, Revised (DSM-III-R). Washington DC: American Psychiatric Association 1987
13. th ed, Text Revision (DSM-IV). Washington DC: American Psychiatric Association 1994.
14. World Health Organization. The ICD-10 classification of mental and behavioural disorders - clinical descriptions and diagnostic guidelines. Geneva: WHO 1992.
15. Treloar AJ, MacDonald MJ. Outcome of delirium-I: outcome of delirium diagnosed by DSM-IIIR, ICD-10 and CAMDEX and derivation of reversible cognitive dysfunction scale among acute geriatric inpatients. Int J Geriatr Psychiatry 1997 12: 609-13.
16. Laurila J, Pitkala K, Strandberg T, Tivilis R. Impact of different diagnostic criteria on prognosis of delirium: a prospective study. Dement Geriatr Cogn Disord 2004 18: 240-4
17. Gupta N, de Jonghe J, Schieveld J, Leonard M, Meagher D. Delirium phenomenology: what can we learn from the symptoms of delirium? J Psychosom Res 2008 65: 215-22
18. Gleason OC. Delirium. Am Fam Physician 2003 67: 1027-34.
19. Meagher D. Delirium: the role of psychiatry. Adv Psychiatric Treatment 2001 7: 433-43.
20. Meagher D, Moran M, Raju B, Leonard M, Donnelly S, Saunders J, et al. A new data-based motor subtype schema for delirium. J Neuropsychiatry Clin Neurosci 2008 20: 185-93
21. McCusker J, Cole M, Dendukuri N, Han L, Belzile E. The course of delirium in older medical inpatients a prospective study. J Gen Intern Med 2003 18: 696-704.
22. Inouye S, Viscili C, Horwitz R, Hurst L, Tinetti M. A predictive model for delirium in hospitalised elderly medical patients based on admission characteristics. Ann Intern Med 1993 119: 474-80.
23. Inouye SK, Charpentier PA. Precipitating factors for delirium in hospitalized elderly persons a predictive model and interrelationship with baseline vulnerability. JAMA 1996 275: 852-7.
24. Schuurmans M, Duursma S, Shortridge-Baggett LM. Early recognition of delirium: review of the literature. J Clin Nurs 2001 10: 721-9.
25. Irving K, Fick D, Foreman M. Delirium: a new appraisal of an old problem. Int J Older People Nurs 2006 1: 106-12
26. Elie M, Cole M, Primeau F, Bellavance F. Delirium risk factors in elderly hospital patients. J Gen Intern Med 1998 13: 204-12.
27. Bellelli G, Speciale S, Trabucchi M. Predictors of delirium during in-hospital rehabilitation in elderly patients after hip arthroplasty. Age Ageing 2005 34: 532.
28. Eden BM, Foreman MD, Sisk R. Delirium: comparison of four predictive models in hospitalized critically ill elderly patients. Appl Nurs Res 1998 11: 27-35.
29. Freter S, George J, Dunbar M, Morrison M, MacKnight C, Rockwood K. Prediction of delirium in fractured neck of femur as part of routine preoperative nursing care. Age Ageing 2005 34 387-8.
30. Gaudreau JD, Gagnon P, Harel F, Roy MA, Tremblay A. Psychoactive medications and risk of delirium in hospitalized cancer patients. J Clin Oncol 2005 23: 6712-8
31. Gruber-Baldini A, Zimmerman S, Morrison R, Grattan L, Hebel J, Dolan M, et al. Cognitive impairment in hip fracture patients: timing of detection and longitudinal follow-up. J Am Geriatr Soc 2003 51: 1227-36.
32. Lou M, Dai Y, Huang G, Yu P. Postoperative cognitive changes among older Taiwanese patients. J Clin Nurs 2003 12: 579-88.
33. Martin NJ, Stones MJ, Young JE, Beadard M. Development of delirium: a prospective cohort study in a community hospital. Int Psychogeriatr 2000 12: 117-27.
34. O'Keeffe ST. Predicting delirium in elderly patients: development and validation of a risk-stratification model. Age Ageing 1996 25: 317-21.
35. Pompei P, Foreman M, Rudberg MA, Inouye SK, Braund V, Cassel CK. Delirium in hospitalized older persons: outcomes and predictors. JAMA 1994 42: 809-15.
36. Schor JD, Levkoff SE, Lipsitz LA, Reilly CH, Cleary PD, Rowe JW, et al. Risk factors for delirium in hospitalized elderly. JAMA 1992 267: 827-31.
37. Schuurmans M, Duursma S, Shortridge-Baggett L, Clevers G, Pel-Littel R. Elderly patients with a hip fracture: the risk for delirium. Appl Nurs Res 2003 16: 75-84.
38. Williams-Russo P, Urquhart BL, Sharrock NE, Charlson ME. Post-operative delirium: predictors and prognosis in elderly orthopedic patients. J Am Geriatr Soc1992 40: 759-67
39. Marcantonio E, Simon S, Bergmann M, Jones R, Murphy K, Morris J. Delirium symptoms in post-acute care: prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc 2003 51: 4-9.
40. Lou M, Yu P, Huang G, Dai Y. Predicting post-surgical cognitive disturbance in older Taiwanese patients. Int J Nurs Stud 2004 41: 29-41.
41. Edlund A, Lundstrom M, Bronnstrom B, Bucht G, Gustafson Y. Delirium before and after operation for femoral neck fracture. J Am Geriatr Soc 2001 49: 1335-40
42. Olin K, Eriksdotter-Johagen M, Jansson A, Herrington M, Kristiansson M, Permert J. Postoperative delirium in elderly patients after major abdominal surgery. Br J Surg 2005 92:1559-64.
43. Williams MA, Campbell EB, Raynor SM, Mlynarczyk SM, Ward SE. Reducing acute confusional states in elderly patients with hip fractures. Res Nurs Health 1985 8: 329-37
44. Feldt KS, Griffin PL. Delirium in hip-fractured elders. Clin Gerontol 1999 20: 75-8.
45. Van Der Mast RC. Pathophysiology of delirium. J Geriatr Psychiatry Neurol 1998 11: 138-45.
46. Mussi C, Ferrari R, Ascari S, Salvioli G. Importance of serum anticholinergic activity in the assessment of elderly patients with delirium. J Geriatr Psychiatry Neurol 1999 12: 82-6.
47. Flacker JM, Cummings V, Mach JR Jr, Bettin K, Kiely DK The association of serum anticholinergic activity with delirium in elderly medical patients. Am J Geriatr Psychogeriatr 1998 10: 421-33
48. Thomas RI, Cameron DJ, Fahs MC. A prospective study of delirium and prolonged hospital stay: exploratory study. Arch Gen Psychiatry 1988 45: 937-40.
49. Tune LE, Damlouji NF, Holland A, Gardner TJ, Folstein MF, Coyle JT. Association of postoperative delirium with raised serum levels of anticholinergic drugs. Lancet 1981 2: 651-3.
50. Folstein MF, Folstein SE, McHugh PR. Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975 12: 189-98.
51. Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE. Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics 1996 37: 533-46
52. Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatr Res 1988 23: 89-97.
53. Hart RP, Best AM, Sessler CN, Levenson JL. Abbreviated Cognitive Test for delirium. J Psychosom Res 1997 43: 417-23.
54. Neelon VJ, Champagne MT, Carlson JR, Funk SG. The NEECHAM confusion scale: construction, validation, and clinical testing. Nurs Res1996 45: 324-30.
55. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method, a new method for the detection of delirium. Ann Intern Med 1990 113: 941-8.
56. Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 2001 286: 2703-10
57. Ely EW, Margolin R, Francis J, May L, Truman B, Dittus R, et al. Evaluation of delirium in critically ill patients: Validation of the confusion assessment method for the intensive care unit (CAM-ICU). Crit Care Med 2001 29: 1370-9.
58. Trzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of delirium rating scale revised-98: comparison to the delirium rating scale and cognitive test for delirium. J Neuropsychiatry Clin Neurosci 2001 13: 229-42
59. Breitbart W, Rosenfeld B, Roth A, Smith MJ, Cohen K, Passik S. The Memorial Delirium Assessment Scale. J Pain Symptom Manage 1997 13:128-37.
60. Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalised patients: The Nursing Delirium Screening Scale. J Pain Symptom Manage 2005 29: 368-75.
61. Schuurmans MJ, Shortridge-Baggett LM, Duursma SA. The Delirium Observation Screening Scale: a screening instrument for delirium. Res Theory Nurs Pract 2003 17: 31-50
62. Albert MS, Levkoff SE, Reilly C, Liptzin B, Pilgrim D, Cleary PD, et al. The delirium symptom interview: an interview for the detection of delirium symptoms in hospitalized patients. J Geriatr Psychiatry Neurol 1992 5: 14-21.
63. O'Keeffe ST. Rating the severity of delirium: the Delirium Assessment Scale. Int J Geriatr Psychiatry 2004 9: 551-6.
64. McCusker J, Cole M, Bellavance F, Primeau F. Reliability and validity of a new measure of severity of delirium. Int Psychogeriatr 1998 10: 421-33.
65. McCusker J, Cole MG, Dendukuri N, Belzile E. The delirium index, a measure of the severity of delirium: new findings on reliability, validity, and responsiveness. J Am Geriatr Soc 2004; 52: 1744-9.
66. de Jonghe JF, Kalisvaart KJ, Timmers JF, Kat MG, Jackson JC. Delirium-O-Meter: a nurses' rating scale for monitoring delirium severity in geriatric patients. Int J Geriatr Psychiatry 2005; 20: 1158-66.
67. Trzepacz PT, Mulsant BH, Dew MA, Pasternak R, Sweet RA, Zubenko GS. Is delirium different when it occurs in dementia? A study using the delirium rating scale. J Neuropsychiatry Clin Neurosci 1998; 10: 199-204.
68. Meagher D, Leonard M. The active management of delirium: improving detection and treatment. Adv Psychiatric Treatment 2008; 14: 292-301.
69. McCaffrey R, Locsin R. The effect of music listening on acute confusion and delirium in elders undergoing elective hip and knee surgery. J Clin Nurs 2004; 13: 91-6.
70. American Psychiatric Association. Practice guideline for the treatment of patients with delirium. Am J Psychiatry 1999; 156: 1-20.
71. Gleason OC. Donepezil for postoperative delirium. Psychosomatics 2003; 44: 437-8.
72. Hori K, Tominaga I, Inada T, Oda T, Hirai S, Hori I, et al. Donepezil-responsive alcohol-related prolonged delirium. Psychiatry Clin Neurosci 2003; 57: 603-4.
73. Kalisvaart CJ, Boelaarts L, De Jonghe JFM, Kat MG. Successful treatment of three elderly patients suffering from prolonged delirium using the cholinesterase inhibitor rivastigmine. Ned Tijdschr Geneeskd 2004; 148: 1501-4
74. Kobayashi K, Higashima M, Mutou K, Kidani T, Tachibana O, Yamashita J, et al. Severe delirium due to basal forebrain vascular lesion and efficacy of donepezil. Prog Neuro-Psychopharmacol Biol Psychiatry 2004; 28: 1189-94
75. Moretti R, Torre P, Antonello R, Cattaruzza T, Cazzato G. Cholinesterase inhibition as a possible therapy for delirium in vascular dementia: a controlled, open 24-month study of 246 patients. Am J Alzheimers Dis Other Demen 2004; 19: 333-9.
76. Lacasse H, Perreault MM, Williamson DR. Systematic review of antipsychotics for the treatment of hospital-associated delirium in medically or surgically ill patients. Ann Pharmacother 2006; 40: 1966-73.
77. Sipahimalani A, Sime RM, Masand PS. Treatment of delirium with risperidone. Int J Geriatr Psychopharmacol 1997; 1: 24-6.
78. Liu CY, Juang YY, Liang HY, Lin NC, Yeh EK. Efficacy of risperidone in treating the hyperactive symptoms of delirium. Int Clin Psychopharmacol 2004; 19: 165-8.
79. Mittal D, Jimerson NA, Neely EP, Johnson WD, Kennedy RE, Torres RA, et al. Risperidone in the treatment of delirium: Results from a prospective open-label trial. J Clin Psychiatry 2004; 65: 662-7.
80. Horikawa N, Yamazaki T, Miyamoto K, Kurosawa A, Oiso H, Matsumoto F, et al. Treatment of delirium with risperidone: Results of a prospective open trial with 10 patients. Gen Hosp Psychiatry 2003; 25: 289-92.
81. Han C, Kim Y. A double-blind trial of risperidone and haloperidol for the treatment of delirium. Psychosomatics 2004; 45: 297-301.
82. Sipahimalani A, Masand PS. Olanzapine in the treatment of delirium. Psychosomatics 1998; 39: 422-9
83. Kim, K, Pae C, Chae J, Bahk WM, Jun T. An open pilot trial of olanzapine for delirium in the Korean population. Psychiatry Clin Neurosci 2001; 55: 515-9.
84. Breitbart W, Tremblay A, Gibson C. An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients. Psychosomatics 2002; 43:175-82.
85. Skrobik Y, Bergeron N, Dumont M, Gottfried SB. Olanzapine vs haloperidol: Treating delirium in a critical care setting. Intensive Care Med 2004; 30: 444-9.
86. Hu H, Deng W, Yang H. A prospective random control study comparison of olanzapine and haloperidol in senile delirium. Chongging Med J 2004; 8:1234-7.
87. Lee Y, Lee J, Rim HD, Kim SH, Chung US, Cho GA, et al. A comparative study of haloperidol and quetiapine in the treatment of delirium: a preliminary randomized open label, flexible dose trial. Eur Neuropsychopharmacol 2006; 16 (Suppl 4): S488-9.
88. Shinno H, Matsuoka T, Yamamoto O, Noma Y, Hikasa S, Takebayashi M, et al. Successful treatment with quetiapine for delirium in terminally ill cancer patients. Psychogeriatrics 2007; 7: 64-8.
89. Omura K, Amano N. Clinical experience of quetiapine in 24 elderly patients with delirium. Psychogeriatrics 2003; 3: 69-72.
90. Maneeton B, Maneeton N, Srisurapanont M. An open-label study of quetiapine for delirium. J Med Assoc Thai 2007; 90: 2158-63.
91. Lee KU, Won WY, Lee HK, Kweon YS, Lee CT, Pae CU, et al. Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study. Int Clin Psychopharmacol 2005; 20: 311-4.
92. Alexopoulos GS, Streim J, Carpenter D, Docherty JP; Expert Consensus Panel for Using Antipsychotic Drugs in Older Patients. Using antipsychotic agents in older patients. J Clin Psychiatry 2004; 65 (Suppl 2): 5-99.
93. Gaudreau JD, Gagnon P, Harel F, Roy MA, Tremblay A. Psychoactive medications and risk of delirium in hospitalized cancer patients. J Clin Oncol 2005; 23: 6712-8.
94. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001; 49: 516-22.
95. Aizawa K, Kanai T, Saikawa Y, Takabayashi T, Kawano Y, Miyazawa N, et al. A novel approach to the prevention of postoperative delirium in the elderly after gastrointestinal surgery. Surg Today 2002; 32: 310-4.
96. Kalisvaart KJ, de Jonghe JF, Bogaards MJ, Vreeswijk R, Egberts TC, Burger BJ, et al. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc 2005; 53:1658-66.
97. Sampson EL, Raven PR, Ndhlovu PN, Vallance A, Garlick N, Watts J, et al. A randomized, double-blind, placebo-controlled trial of donepezil hydrochloride (Aricept) for reducing the incidence of postoperative delirium after elective total hip replacement. Int J Geriatr Psychiatry 2007; 22: 343-9
98. Manos PJ, Wu R. The duration of delirium in medical and postoperative patients referred for psychiatric consultation. Ann Clin Psychiatry 1997; 9: 219-26.
99. Levkoff SE, Liptzin B, Evans D, Cleary PD, Lipsitz LA, Wetle T, et al. Progression and resolution of delirium in elderly patients hospitalized for acute care. Am J Geriatr Psychiatry 1994; 2: 230-8.
100. Rockwood K, Cosway S, Carver D, Jarrett P, Stadnyk K, Fisk J. The risk of dementia and death after delirium. Age Ageing 1999; 28: 551-6.
101. Jackson JC, Hart RP, Gordon SM, Shintani A, Truman B, May L, et al. Six-month neuropsychological outcome of medical intensive care unit patients. Crit Care Med 2003; 31: 1226-34.
102. Hopkins RO, Weaver LK, Collingridge D, Parkinson RB, Chan KJ, Orme JF Jr. Two-year cognitive, emotional, and quality-of-life outcomes in acute respiratory distress syndrome. Am J Respir Crit Care Med 2005; 171: 340-7
103. Wacker P, Nunes PV, Cabrita H, Forlenza OV. Postoperative delirium is associated with poor cognitive outcome and dementia. Dement Geriatr Cogn Disord 2006; 21: 221-7
104. Lin SM, Liu CY, Wang CH, Lin HC, Huang CD, Huang PY, et al. The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med 2004; 32: 2254-9
105. Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004; 291: 1753-62.
106. Avasthi A, Sharan P, Kulhara P, Malhotra S, Varma VK. Psychiatric profiles in medical-surgical populations: need for a focused approach to consultation-liaison psychiatry in developing countries. Indian J Psychiatry 1998; 40: 224-30
107. Chatterjee SB, Kutty PR. A study of psychiatric referrals in Military practice in India. Indian J Psychiatry 1977 19: 32-8.
108. Jindal RC, Hemrajani DK. A study of psychiatric referrals in a general hospital. Indian J Psychiatry 1980; 22: 108-10.
109. Malhotra S, Malhotra A. Liaison psychiatry in an Indian general hospital. Gen Hosp Psychiatry 1984 6: 266-70.
110. Parekh HC, Deshmukh DK, Bagadia VN, Vahia NA. Analysis of indoor psychiatric referrals in a general hospital. Indian J Psychiatry 1968 10: 81-3.
111. Prabhakaran N. Inpatient psychiatric referrals in a general hospital. Indian J Psychiatry 1968 10: 73-7.
112. Deshpande SN, Sundaram KR, Wig NN. Psychiatric disorders among medically ill in patients in an Indian hospital. Br J Psychiatry1989 154: 504-9.
113. Grover S, Subodh BN, Avasthi A, Chakrabarti S, Kumar S, Sharan P, et al. Prevalence and clinical profile of Delirium: a study from a tertiary care hospital in north India. Gen Hosp Psychiatry 2009 31: 25-9
114. Chaudhury S, Mahar RS, Augustine M. Post-cataractomy delirium a prospective study. Med J Armed Forces India 1991 47: 286-90.
115. Khurana P, Sharma PSVN, Avasthi A. Prevalence of delirium in geriatric hospitalized general medical population. Indian J Psychiatry 2002 44: 41-6.
116. Sood A, Singh P, Gargi PD. Psychiatric morbidity in non-psychiatric geriatric inpatients. Indian J Psychiatry 2006 48: 56-61.
117. Das PP, Grover S, Kumar S. Naltrexone induced delirium: A case report. German J Psychiatry 2005 8: 101-3.
118. Shankar BR. Clozapine-induced delirium. J Neuropsychiatry Clin Neurosci 2008 20: 239-40
119. Madan R, Muralidhar V, Kalia PK, Baraja U, Madan. Diazepam induced delirium. Indian J Ophthalmol 1989 37: 35-6.
120. Khanna S, Ammini A, Saxena S, Mohan D. Hypopituitarism presenting as delirium. Int J Psychiatry Med 1988 18: 89-92
121. Santosh PJ, Malhotra S. Varied psychiatric manifestations of acute intermittent porphyria. Biol Psychiatry1994 36: 744-7
122. Gupta N, Sharma P, Mattoo SK. Effectiveness of Risperidone in Delirium. Can J Psychiatry 2005 50: 75.
123. Gupta N, Sharma P, Prabhakar S. Olanzapine for delirium in parkinsonism: Therapeutic benefits in lieu of adverse consequences. Neurol India 2004 52: 274-5.
124. Grover S, Malhotra S, Bharadwaj R, Subodh BN, Kumar S. Delirium in children and adolescents: a study from India. Int J Psychiatry Med 2009 39: 179-87.