Objective: The primary aim of this study was to evaluate the safety and efficacy of a low-dose Depakote protocol for the treatment of delirium in hospitalized adult patients.

Methods: Participants were selected through a retrospective chart review for 24 months pre and post intervention. Demographic variables were compared using univariate statistics. The primary outcome was patient length of stay (LOS), compared using a Mann Whitney-U test. The three other outcomes of antipsychotic administration, benzodiazepine administration, and incidence of injury were measured using separate Fisher's exact tests. Mann Whitney-U tests were conducted to compare antipsychotic and benzodiazepine dose administration using haloperidol and lorazepam equivalents. Incidence and severity of adverse effects were analyzed using descriptive statistics for patients administered the Depakote protocol. IBM SPSS version 27 was used to conduct the statistical analysis.

Results: The retrospective analysis evaluated 102 patient records. The hospital length of stay showed no statistically significant difference between-groups (median non-Depakote 7.5, median Depakote 7.0, z= -.188, p= .881). Antipsychotic use was measured in haloperidol equivalents, while benzodiazepine use was measured in lorazepam equivalents. Antipsychotic utilization decreased significantly from 92.3% (non-Depakote group) to 42% (Depakote group) (p<.001). Similarly, benzodiazepine utilization also decreased significantly from 57.7% (non-Depakote group) to 6% (Depakote group) (p<.001). Median total antipsychotic dosage also decreased significantly from 14.5mg (non-Depakote group) to 2.5mg (Depakote group) (z= -4.987, pxtagstartz.001). The median total benzodiazepine dosage did not change significantly (median non-Depakote 2mg, median Depakote 1mg, z=-1.409, p=.159). The mean time to Depakote initiation was 4.14 days. There was a reduction in the occurrence of delirium-related injury or complication from 7.7% (non-Depakote group) to 2% (Depakote group) though this was not statistically significant (p=.363).xtagstartz/p>

Dr. Abhijai Singh

Medical college of Wisconsin

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