Adjunctive Valproic Acid in Management-Refractory Hyperactive Delirium: A Case Series and Rationale

Area of Science:

• Neuroscience
• Pharmacology
• Critical Care Medicine

Background:

• Delirium, particularly hyperactive delirium, presents significant management challenges.
• Standard therapeutic interventions for delirium are not always effective.
• Refractory cases necessitate exploration of alternative treatment strategies.

Purpose of the Study:

• To evaluate the efficacy of valproic acid as an adjunctive therapy for management-refractory hyperactive delirium.
• To assess the response rate and resolution of symptoms in patients receiving valproic acid.

Main Methods:

• A cohort of sixteen patients with hyperactive delirium, refractory to standard treatments, was identified.
• Adjunctive valproic acid was administered to these patients.
• Clinical outcomes, specifically the resolution of hyperactive delirium, were monitored.

Main Results:

• Adjunctive valproic acid treatment resulted in a positive response in all sixteen patients.
• Complete resolution of hyperactive delirium was observed in thirteen out of sixteen patients (81.25%).
• The findings suggest a significant therapeutic benefit of valproic acid in this patient group.

Conclusions:

• Valproic acid demonstrates considerable efficacy as an adjunctive treatment for hyperactive delirium that does not respond to conventional therapies.
• This study provides evidence supporting the use of valproic acid in clinical settings for refractory hyperactive delirium.
• Further research is warranted to elucidate the precise mechanisms and optimize its application.