Case Report: Marked Effect of Cilostazol on Delirium in a Dementia Patient with Deep White Matter Lesions: Potential Etiology-Targeted Pharmacotherapy for Delirium

Authors

  • Satoshi Ueda Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan
  • Yoshiro Okubo Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan

DOI:

https://doi.org/10.12970/2310-8231.2016.04.01.1

Keywords:

Delirium, cilostazol, antipsychotics, etiology-targeted therapy.

Abstract

Antipsychotics have been mainly used as pharmacotherapy for delirium. Their use is, however, only considered a symptom-targeted, but not an etiology-targeted therapy. Moreover, antipsychotics may also have some adverse effects in elderly patients. We report a case of an elderly dementia patient with deep white matter lesions whose delirium was markedly resolved with a platelet aggregation inhibitor, cilostazol. No antipsychotic drugs were used. To our knowledge, there have been no reports regarding the effect of cilostazol on delirium, despite not a few studies on cognitive function of Alzheimer disease and cerebrovascular disease. This case suggests that cilostazol is a potentially effective agent as an etiology-targeted therapy for delirium due to its possible increased regional cerebral blood flow.

References

Seitz DP, Gill SS, van Zyl LT. Antipsychotics in the treatment of delirium: a systematic review. J Clin Psychiatry 2007; 68(1): 11-21. http://dx.doi.org/10.4088/JCP.v68n0102

Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet 2014; 383(9920): 911-22. http://dx.doi.org/10.1016/S0140-6736(13)60688-1

Fong TG, Tulebaev SR, Inouye SK. Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol 2009; 5(4): 210-20. http://dx.doi.org/10.1038/nrneurol.2009.24

Heckman PR, Wouters C, Prickaerts J. Phosphodiesterase inhibitors as a target for cognition enhancement in aging and Alzheimer's disease: a translational overview. Curr Pharm Des 2015; 21(3): 317-31. http://dx.doi.org/10.2174/1381612820666140826114601

Taguchi A, Takata Y, Ihara M, et al. Cilostazol improves cognitive function in patients with mild cognitive impairment: a retrospective analysis. Psychogeriatrics 2013; 13(3): 164-9. http://dx.doi.org/10.1111/psyg.12021

Kim YR, Kim HN, Hong KW et al. Anti-depressant effects of phosphodiesterase 3 inhibitor cilostazol in chronic mild stress-treated mice after ischemic stroke. Psychopharmacology (Berl) 2015; [Epub ahead of print].

Downloads

Published

2016-03-06

Issue

Section

Articles