Delirium , also called D elirium Tremens, is a state of mental confusion that arises abruptly, causing changes in consciousness, attention, behavior, memory, thinking, orientation or another area of cognition, causing behavior that often alternates between excessive sleepiness and agitation.
Also known as Acute Confusional State, delirium is related to changes in brain activity, and it usually affects mainly hospitalized elderly or people with some type of dementia, such as Alzheimer's disease, or people with alcohol and drug withdrawal, despite its exact cause is still unclear.
To treat delirium, it is recommended, initially, to correct the factors that may be triggering this situation, such as treating an infection, adjusting medication, organizing the environment or regularizing sleep, for example. In the most severe cases, the doctor may also recommend the use of antipsychotic drugs, such as Haloperidol, Risperidone, Quetiapine or Olanzapine.
How to identify
The main symptoms that indicate delirium are:
- Inattention and agitation; Drowsiness or apathy; Inability to obey commands; Inversion of the sleep-wake cycle, in which one remains awake at night and drowsy during the day; Disorientation; Not recognizing family members or acquaintances; Memory changes, even for remember words; irritability and frequent anger; sudden mood swings; hallucinations; anxiety.
An important characteristic of delirium is its acute installation, from one hour to the next, and, in addition, it has a fluctuating course, that is, it varies between moments of normality, agitation or drowsiness throughout the same day.
How to confirm
The diagnosis of delirium can be confirmed by the doctor, using questionnaires such as the Confusion Assessment Method (CAM), which indicates that the fundamental characteristics for confirmation are:
| A) Acute change in mental status; |
Delirium is considered in the presence of items A and B + C and / or D |
| B) Marked decrease in attention; | |
| C) Change in the level of consciousness (agitation or drowsiness); | |
| D) Disorganized thinking. |
It is important to remember that " Delirium" is different from "Delirium", as this means a psychiatric alteration characterized by the formation of a false judgment about something, in which the person has a conviction that something is impossible. In addition, unlike delirium , delirium has no organic cause and does not cause changes in attention or awareness.
Learn more about this change in What is it and how to identify the delusion.
Main causes
The main risk factors for the development of delirium include:
- Age over 65; Having some form of dementia, such as Alzheimer's disease or dementia by Lewy bodies, for example; Use of certain medications, such as sedatives, sleeping pills, amphetamine, antihistamines or some antibiotics, for example; hospitalized; Having undergone surgery; Malnutrition; Dehydration; Alcohol or drug abuse; Physical restriction, such as being bedridden; Use of many medications; Sleep deprivation; Change of environment; Having any physical illness, such as infection, heart failure or pain kidneys, for example.
In the elderly, delirium may be the only manifestation of any serious illness, such as pneumonia, urinary tract infection, heart attack, stroke or changes in blood electrolytes, for example, so whenever it arises, it must be quickly evaluated by the geriatrician or general practitioner.
How the treatment is done
The main way to treat delirium is through strategies that help guide the person, such as allowing contact with family members during hospitalization, keeping the person oriented in relation to time, giving them access to the calendar and clock and maintaining an environment calm, especially at night, to allow a peaceful sleep.
These strategies encourage a return to awareness and improved behavior. In addition, elderly people who wear glasses or hearing aids must have access to them, avoiding difficulties in understanding and communicating. Check out more guidance on what to do to live better with the elderly with mental confusion.
The use of medications is indicated by the doctor, and should be reserved for patients with significant agitation, representing a risk to their own safety or that of others. The most used remedies are antipsychotics, such as Haloperidol, Risperidone, Quetiapine, Olanzapine or Clozapine, for example. In cases of delirium caused by abstinence from alcohol or illicit drugs, the use of sedative medications, such as Diazepam, Clonazepam or Lorazepam, for example, is indicated.
