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Utilisation des psychostimulants chez les patients en fin de vie atteints de delirium hypoactif et de troubles cognitifs : revue de la litterature Elie D; Gagnon P; Gagnon B; Giguere ACan J Psychiatry 2010[Jun]; 55 (6): 386-93OBJECTIVE: To review the research about psychostimulant effects on cognitive functions in end-of-life patients diagnosed with hypoactive delirium or cognitive disorders. METHOD: The MEDLINE (1966-March 2008), Embase (1974-March 2008), PsycINFO (1806-March 2008), IPA (1970-March 2008), CINAHL (1982-March 2008), ISI Web of Science (1945-March 2008), Current Contents (March 2007-March 2008), Access Medicine (2001-March 2008), and ProQuest Dissertations & Theses (1980-March 2008) databases were searched with keywords related to delirium, cognition, psychostimulants, and palliative care for French or English articles in a dementia-free and hyperactive delirium-free end-of-life population. Cognitive functions had to be assessed before and after initiation of the psychostimulant treatment. Moreover, treatment had to be initiated after the onset of cognitive impairments. RESULTS: A total of 173 studies were screened. Five studies on methylphenidate and 1 study on caffeine met inclusion criteria and were included in this review. Two studies were case reports, 2 were open-label trials, and 2 were double-blind, crossover randomized placebo-controlled trials. Three studies were conducted with hypoactive delirium patients and all studies were conducted in an advanced cancer patient population. CONCLUSIONS: The reviewed studies support the use of methylphenidate to improve end-of-life patient cognitive functions, particularly in the case of hypoactive delirium. Caffeine seems to have beneficial effects on psychomotor activity. Further well-designed studies are needed to consolidate these findings.|*Palliative Care[MESH]|*Terminal Care[MESH]|Aged[MESH]|Caffeine/*therapeutic use[MESH]|Central Nervous System Stimulants/*therapeutic use[MESH]|Cognition Disorders/*drug therapy[MESH]|Confusion/drug therapy[MESH]|Delirium/*drug therapy[MESH]|Depressive Disorder/drug therapy[MESH]|Dose-Response Relationship, Drug[MESH]|Double-Blind Method[MESH]|Drug Administration Schedule[MESH]|Humans[MESH]|Mental Status Schedule[MESH]|Methylphenidate/*therapeutic use[MESH]|Middle Aged[MESH]|Psychomotor Disorders/*drug therapy[MESH]|Randomized Controlled Trials as Topic[MESH] |
