MIANSERIN SUPPOSITORIES IN THE TREATMENT OF POSTOPERATIVE DELIRIUM

Mianserin suppositories (10-90 mg) were administered at bedtime to 16 patients with post-operative delirium (mean age 69.5 years). By the De lirium Rating Scale (DRS: Trzepacz et al., 1988), the average score de creased from 21.2 prior to administration to 14.5 on the first day of treatment and to 7.1 on the seventh day. Improvement was observed in a ll cases (marked in 85 per cent and slight in 15 per cent). The plasma concentration of mianserin was 65 ng/ml on day 1, 93 ng/ml on day 3 a nd 65 ng/ml on day 5, having reached therapeutic levels within 24 h of beginning treatment. Decreases in the free-3-methoxy-4-hydroxyphenyl( ethylene)glycol (MHPG) concentrations in plasma were observed after dr ug administration, but free-homovanillic acid (HVA) concentrations in plasma showed no significant change with the drug treatment. We consid er mianserin suppositories to be an effective treatment for post-opera tive delirium. (C) 1997 John Wiley & Sons, Ltd.