COMPARISON OF EFFICACY OF MELATONIN VS OLANZAPINE IN TREATING DELIRIUM IN CRITICALLY ILL PATIENTS: A PROSPECTIVE RANDOMIZED CONTROL STUDY

Delirium is very common in patients admitted to intensive care units (ICU) and leads to increased morbidity. It has multi-factorial aetiology and sleep deprivation as well as sleep quality play important role. The anti-psychotic drug olanzapine is established for treatment but has limitation of prolongation of Qtc interval. Melatonin, a sleep modulating compound, is devoid of major side effects in therapeutic doses and has been used in prevention of delirium. This study was aimed at comparing the effectiveness of melatonin vs olanzapine in treating delirium in critically ill patients. Methods: This prospective randomized double blind comparative study was conducted after approval from institutional ethical committee and registration with CTRI (CTRI/2021/05/033908). All ICU patients were assessed daily for the development of delirium, using CAM-ICU (Confusion Assessment Method) score. Those diagnosed with delirium and fullling inclusion criteria, were randomly allocated in three groups of 50 each, by computer generated tables. Group M: receiving melatonin 9mg; Group O: receiving olanzapine5mg; Group C: receiving haloperidol 2.5mg, as daily oral doses. The participants were tested daily using revised delirium rating scale (DRS-R-98) scores and the duration and severity of delirium was noted. The side effects were also noted. The data was analysed using independent t test, p value <0.05 was considered statistically signicant. Results: There was no signicant difference between the olanzapine and melatonin group in terms of DRS -R98 score from baseline to all the 5 consecutive days. Conclusion: Melatonin is as effective as olanzapine in the treatment of delirium