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Psychiatry · Organic psychiatry: delirium drug treatment
Sample itemA 78-year-old with hyperactive delirium after pneumonia is distressed and trying to pull out his drip. After non-drug measures fail, which drug is the usual choice?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Low-dose haloperidol
Low-dose haloperidol, for example 0.5 to 1 mg, is the usual drug to control dangerous agitation in delirium, after treating the cause and using environmental measures. Benzodiazepines can worsen confusion except in alcohol or sedative withdrawal. Anticholinergic drugs such as amitriptyline can precipitate delirium.
Option by option
A. Phenobarbitone
Barbiturates add sedation and respiratory risk.
B. Low-dose haloperidol (correct)
Correct. Low-dose haloperidol is standard for severe agitation.
C. Amitriptyline
Amitriptyline is anticholinergic and may aggravate delirium.
D. High-dose diazepam
High-dose diazepam may worsen confusion and cause respiratory depression.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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