Namenda to Prevent Post-Operative Delirium
Namenda as Prevention for Post-Operative Delirium
2 other identifiers
interventional
30
1 country
1
Brief Summary
Post Operative Delirium is a common and serious risk of surgery. Delirium, when it occurs is associated with an increased risk of mortality, increase length of stay, and more adverse outcomes in general, including increased risk of higher level of care required at discharge. Namenda, which is currently approved for moderate or severe Alzheimer's disease has a unique mechanism of action than other drugs for this condition. It may have the ability to protect the brain from more severe consequences of hypoxia, or hypoglycemia. Hence it is being looked at in this study to see if it can reduce the incidence and/or severity of delirium post-operatively.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_4
Started Mar 2006
Shorter than P25 for phase_4
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
March 1, 2006
CompletedFirst Submitted
Initial submission to the registry
March 14, 2006
CompletedFirst Posted
Study publicly available on registry
March 16, 2006
CompletedStudy Completion
Last participant's last visit for all outcomes
September 1, 2006
CompletedJune 3, 2015
December 1, 2009
March 14, 2006
June 2, 2015
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Incidence and severity of delirium measured by Delirium Rating Scale-Revised-98, MMSE. Confusion Assessment Method, Clock Drawing Tests (CLOX), DSM-IV-TR criteria for Delirium.
Secondary Outcomes (1)
Length and cost of stay, disposition, level of care required post hosptialization, hospitalization satisfaction, number of consultants involved, total costs of care.
Interventions
Eligibility Criteria
You may qualify if:
- Medically stable
- years of age or older
- having elective joint replacement surgery or other orthopedic procedures that are major surgery and require general anesthesia.
You may not qualify if:
- Alcohol or sedative hypnotic abuse or dependence
- Pregnancy
- Dementia or MR/DD patients if they do not have sufficient capacity to understand the consent
- renal impairment or a creatinine of 1.4 or higher
- currently taking cholinesterase inhibitors.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of Rochesterlead
- Forest Laboratoriescollaborator
Study Sites (1)
University of Rochester Medical Center
Rochester, New York, 14642, United States
Related Publications (43)
Schwartz TL, Masand PS. The role of atypical antipsychotics in the treatment of delirium. Psychosomatics. 2002 May-Jun;43(3):171-4. doi: 10.1176/appi.psy.43.3.171.
PMID: 12075031BACKGROUNDBreitbart W, Rosenfeld B, Roth A, Smith MJ, Cohen K, Passik S. The Memorial Delirium Assessment Scale. J Pain Symptom Manage. 1997 Mar;13(3):128-37. doi: 10.1016/s0885-3924(96)00316-8.
PMID: 9114631BACKGROUNDBekker AY, Weeks EJ. Cognitive function after anaesthesia in the elderly. Best Pract Res Clin Anaesthesiol. 2003 Jun;17(2):259-72. doi: 10.1016/s1521-6896(03)00005-3.
PMID: 12817919BACKGROUNDNishikawa K, Nakayama M, Omote K, Namiki A. Recovery characteristics and post-operative delirium after long-duration laparoscope-assisted surgery in elderly patients: propofol-based vs. sevoflurane-based anesthesia. Acta Anaesthesiol Scand. 2004 Feb;48(2):162-8. doi: 10.1111/j.0001-5172.2004.00264.x.
PMID: 14995937BACKGROUNDInouye SK. Delirium in hospitalized elderly patients: recognition, evaluation, and management. Conn Med. 1993 May;57(5):309-15. No abstract available.
PMID: 8319447BACKGROUNDInouye SK, Rushing JT, Foreman MD, Palmer RM, Pompei P. Does delirium contribute to poor hospital outcomes? A three-site epidemiologic study. J Gen Intern Med. 1998 Apr;13(4):234-42. doi: 10.1046/j.1525-1497.1998.00073.x.
PMID: 9565386BACKGROUNDMcCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E. Delirium predicts 12-month mortality. Arch Intern Med. 2002 Feb 25;162(4):457-63. doi: 10.1001/archinte.162.4.457.
PMID: 11863480BACKGROUNDInouye SK. Delirium in hospitalized older patients: recognition and risk factors. J Geriatr Psychiatry Neurol. 1998 Fall;11(3):118-25; discussion 157-8. doi: 10.1177/089198879801100302.
PMID: 9894730BACKGROUNDBreitbart W, Gibson C, Tremblay A. The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics. 2002 May-Jun;43(3):183-94. doi: 10.1176/appi.psy.43.3.183.
PMID: 12075033BACKGROUNDGustafson Y, Berggren D, Brannstrom B, Bucht G, Norberg A, Hansson LI, Winblad B. Acute confusional states in elderly patients treated for femoral neck fracture. J Am Geriatr Soc. 1988 Jun;36(6):525-30. doi: 10.1111/j.1532-5415.1988.tb04023.x.
PMID: 2897391BACKGROUNDSaravay SM, Strain JJ. APM Task Force on Funding Implications of Consultation-Liaison Outcome Studies. Special series introduction: a review of outcome studies. Psychosomatics. 1994 May-Jun;35(3):227-32. doi: 10.1016/S0033-3182(94)71771-0. No abstract available.
PMID: 8036252BACKGROUNDThomas RI, Cameron DJ, Fahs MC. A prospective study of delirium and prolonged hospital stay. Exploratory study. Arch Gen Psychiatry. 1988 Oct;45(10):937-40. doi: 10.1001/archpsyc.1988.01800340065009.
PMID: 3138960BACKGROUNDSchor JD, Levkoff SE, Lipsitz LA, Reilly CH, Cleary PD, Rowe JW, Evans DA. Risk factors for delirium in hospitalized elderly. JAMA. 1992 Feb 12;267(6):827-31.
PMID: 1732655BACKGROUNDCushman LA. Secondary neuropsychiatric complications in stroke: implications for acute care. Arch Phys Med Rehabil. 1988 Oct;69(10):877-9.
PMID: 3178456BACKGROUNDKishi Y, Iwasaki Y, Takezawa K, Kurosawa H, Endo S. Delirium in critical care unit patients admitted through an emergency room. Gen Hosp Psychiatry. 1995 Sep;17(5):371-9. doi: 10.1016/0163-8343(95)00056-w.
PMID: 8522152BACKGROUNDBerggren D, Gustafson Y, Eriksson B, Bucht G, Hansson LI, Reiz S, Winblad B. Postoperative confusion after anesthesia in elderly patients with femoral neck fractures. Anesth Analg. 1987 Jun;66(6):497-504.
PMID: 3578861BACKGROUNDMilbrandt EB, Deppen S, Harrison PL, Shintani AK, Speroff T, Stiles RA, Truman B, Bernard GR, Dittus RS, Ely EW. Costs associated with delirium in mechanically ventilated patients. Crit Care Med. 2004 Apr;32(4):955-62. doi: 10.1097/01.ccm.0000119429.16055.92.
PMID: 15071384BACKGROUNDForeman MD. Prevention and Treatment Strategies for Delirium. Primary Psychiatry 11(11): 52-58, 2004.
BACKGROUNDInouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, Cooney LM Jr. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999 Mar 4;340(9):669-76. doi: 10.1056/NEJM199903043400901.
PMID: 10053175BACKGROUNDBogardus ST Jr, Desai MM, Williams CS, Leo-Summers L, Acampora D, Inouye SK. The effects of a targeted multicomponent delirium intervention on postdischarge outcomes for hospitalized older adults. Am J Med. 2003 Apr 1;114(5):383-90. doi: 10.1016/s0002-9343(02)01569-3.
PMID: 12714128BACKGROUNDRizzo JA, Bogardus ST Jr, Leo-Summers L, Williams CS, Acampora D, Inouye SK. Multicomponent targeted intervention to prevent delirium in hospitalized older patients: what is the economic value? Med Care. 2001 Jul;39(7):740-52. doi: 10.1097/00005650-200107000-00010.
PMID: 11458138BACKGROUNDTrzepacz PT. Delirium. Advances in diagnosis, pathophysiology, and treatment. Psychiatr Clin North Am. 1996 Sep;19(3):429-48. doi: 10.1016/s0193-953x(05)70299-9.
PMID: 8856810BACKGROUNDKawashima T, Yamada S. Delirium caused by donepezil: a case study. J Clin Psychiatry. 2002 Mar;63(3):250-1. doi: 10.4088/jcp.v63n0312f. No abstract available.
PMID: 11926729BACKGROUNDTrzepacz PT. The neuropathogenesis of delirium. A need to focus our research. Psychosomatics. 1994 Jul-Aug;35(4):374-91. doi: 10.1016/S0033-3182(94)71759-X.
PMID: 7916159BACKGROUNDRogawski MA. What is the rationale for new treatment strategies in Alzheimer's disease? CNS Spectr. 2004 Jul;9(7 Suppl 5):6-12. doi: 10.1017/s1092852900024743.
PMID: 15241294BACKGROUNDNelson JK, Schilke DA. The evolution of psychiatric liaison nursing. Perspect Psychiatr Care. 1976 Apr-Jun;14(2):60-5. doi: 10.1111/j.1744-6163.1976.tb01536.x. No abstract available.
PMID: 1046580BACKGROUNDChase TN. Levodopa therapy: consequences of the nonphysiologic replacement of dopamine. Neurology. 1998 May;50(5 Suppl 5):S17-25. doi: 10.1212/wnl.50.5_suppl_5.s17.
PMID: 9591518BACKGROUNDHarrell RG, Othmer E. Postcardiotomy confusion and sleep loss. J Clin Psychiatry. 1987 Nov;48(11):445-6.
PMID: 3680186BACKGROUNDMatsushima E, Nakajima K, Moriya H, Matsuura M, Motomiya T, Kojima T. A psychophysiological study of the development of delirium in coronary care units. Biol Psychiatry. 1997 Jun 15;41(12):1211-7. doi: 10.1016/s0006-3223(96)00219-3.
PMID: 9171911BACKGROUNDFolstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189-98. doi: 10.1016/0022-3956(75)90026-6. No abstract available.
PMID: 1202204BACKGROUNDInouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941-8. doi: 10.7326/0003-4819-113-12-941.
PMID: 2240918BACKGROUNDTrzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of the Delirium Rating Scale-revised-98: comparison with the delirium rating scale and the cognitive test for delirium. J Neuropsychiatry Clin Neurosci. 2001 Spring;13(2):229-42. doi: 10.1176/jnp.13.2.229.
PMID: 11449030BACKGROUNDGleason OC. Donepezil for postoperative delirium. Psychosomatics. 2003 Sep-Oct;44(5):437-8. doi: 10.1176/appi.psy.44.5.437. No abstract available.
PMID: 12954923BACKGROUNDScarpini E, Scheltens P, Feldman H. Treatment of Alzheimer's disease: current status and new perspectives. Lancet Neurol. 2003 Sep;2(9):539-47. doi: 10.1016/s1474-4422(03)00502-7.
PMID: 12941576BACKGROUNDWengel SP, Burke WJ, Roccaforte WH. Donepezil for postoperative delirium associated with Alzheimer's disease. J Am Geriatr Soc. 1999 Mar;47(3):379-80. doi: 10.1111/j.1532-5415.1999.tb03015.x. No abstract available.
PMID: 10078910BACKGROUNDMoster ML, Balcer LJ. The 56th annual meeting of the American Academy of Neurology, San Francisco, California, April 24-30, 2004. J Neuroophthalmol. 2004 Dec;24(4):327-36. doi: 10.1097/00041327-200412000-00012. No abstract available.
PMID: 15662251BACKGROUNDRogawski MA, Wenk GL. The neuropharmacological basis for the use of memantine in the treatment of Alzheimer's disease. CNS Drug Rev. 2003 Fall;9(3):275-308. doi: 10.1111/j.1527-3458.2003.tb00254.x.
PMID: 14530799BACKGROUNDCepeda C, Levine MS. Dopamine and N-methyl-D-aspartate receptor interactions in the neostriatum. Dev Neurosci. 1998;20(1):1-18. doi: 10.1159/000017294.
PMID: 9600386BACKGROUNDCepeda C, Colwell CS, Itri JN, Gruen E, Levine MS. Dopaminergic modulation of early signs of excitotoxicity in visualized rat neostriatal neurons. Eur J Neurosci. 1998 Nov;10(11):3491-7. doi: 10.1046/j.1460-9568.1998.00357.x.
PMID: 9824462BACKGROUNDHuang KX, Bergstrom DA, Ruskin DN, Walters JR. N-methyl-D-aspartate receptor blockade attenuates D1 dopamine receptor modulation of neuronal activity in rat substantia nigra. Synapse. 1998 Sep;30(1):18-29. doi: 10.1002/(SICI)1098-2396(199809)30:13.0.CO;2-N.
PMID: 9704877BACKGROUNDRoyall DR, Cordes JA, Polk M. CLOX: an executive clock drawing task. J Neurol Neurosurg Psychiatry. 1998 May;64(5):588-94. doi: 10.1136/jnnp.64.5.588.
PMID: 9598672BACKGROUNDDiagnostic and Statistical Manual of Mental Disorders, Forth Edition, Text Revision. Washington D.C., American Psychiatric Association, 2000.
BACKGROUNDCohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed. Lawrence Erlbaum Associates, New Jersey.
BACKGROUND
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Michael R Privitera, MD
University of Rochester
Study Design
- Study Type
- interventional
- Phase
- phase 4
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
Study Record Dates
First Submitted
March 14, 2006
First Posted
March 16, 2006
Study Start
March 1, 2006
Study Completion
September 1, 2006
Last Updated
June 3, 2015
Record last verified: 2009-12