Delirium Improvement with Mianserin Suppositories in Cancer Patients

Delirium is a significant problem in palliative medicine, and its proper management and prevention is extremely important. In our cancer center, mianserin suppositories have been included in the hospital formulary and are prescribed for cancer patients who have dysphagia; however, previous studies have shown only limited data on the effect of mianserin suppositories. Therefore, in this study, we compared the therapeutic effect of mianserin suppositories with mianserin tablets for improvement of delirium. Subjects were 66 cancer patients who had received either mianserin suppositories or mianserin tablets for delirium at our cancer center between April 2013 and March 2015. Delirium was evaluated using the Intensive Care Delirium Screening Check list (ICDSC). The improvement rates of delirium for 7 days were compared between the two groups using Fisher’s exact test. The dose of mianserin was 30-60 mg/day (median dose 30mg/day) in the suppository group (n=31) and 10-60 mg/day (median dose 20mg/day) in the tablet group (n=35). The improvement rates of delirium during the 7-day test period were 71.0% in the suppository group and 62.9% in the tablet group. There was no significant difference. (P=0.60) Considering the results of this study, mianserin suppositories have an equal delirium improvement effect compared with mianserin tablets. These findings also suggest that mianserin suppositories can be effectively used to improve delirium in patients with dysphagia.