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SPECIFICS OF ACUTE CONFUSION TREATMENT
It may be necessary to give some calming medication at the beginning of treatment when a person is excessively agitated. It is best not to use the drugs known as benzodiazepines (Valium/ diazepam, Mogadon/nitrazepam, etc.) as these may have the opposite effect and, by removing all inhibitions, cause the person to be even more disturbed.
If drugs need to be used then the ones with the least side-effects should be tried first. One drug used widely in elderly people for its calming effects in confusional states is Melleril (thioridazine). It can be given in small doses, e.g. 10 mg, and the dose increased until the desired effect is achieved. This should be a lessening of agitation and not a very sleepy or stuporose person liable to fall or be incontinent because of the drowsiness. Other drugs are stronger and can cause more side-effects, though occasionally they are needed, e.g. Largactil/chlorpromazine and Haldol or Serenace/ haloperidol. This latter drug can be very helpful when the confusional state is accompanied by either severe paranoia (fear of being harmed) or aggression. All of these drugs have some side-effects the most serious being stiffness and immobility - a form of Parkinson\'s disease called Parkinsonism. The drugs may have to be given by injection if the person is very disturbed or is unable to take medication by mouth. Once the underlying cause has responded to treatment the calming medication can be stopped as most people will return to normal. The medication should not be carried on just in case.
Prompt recognition by carers and prompt diagnosis and action by GPs are the cornerstones of effective treatment.
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GENERAL HEALTH
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