# The Efficacy of Lacosamide in the Treatment of Delirium Complicated With Ileus: Four Cases

## TL;DR

Lacosamide, an antiepileptic drug, may be a safe treatment for delirium in elderly patients with ileus, avoiding adverse effects seen with other drugs.

## Contribution

This paper presents three successful cases of using lacosamide to treat delirium complicated by ileus, suggesting it as a safer alternative.

## Key findings

- Lacosamide successfully managed antipsychotic-induced paralytic ileus in three elderly patients.
- Lacosamide caused no severe adverse effects or psychiatric symptoms in treated patients.
- Lacosamide's mechanism avoids antagonism of systems linked to ileus, making it a potentially safer option.

## Abstract

Delirium is a common disease in elderly patients and requires medications, although nondrug interventions are recommended. When delirious patients are complicated with ileus, the selection of drugs would be difficult. In this paper, three cases of antipsychotic‐induced paralytic ileus successfully managed with lacosamide are presented without any severe adverse effects, including psychiatric symptoms. Lacosamide is a newer antiepileptic drug that acts on the sodium channels. Drug‐induced eruptions are rare compared to other antiepileptics, such as carbamazepine and lamotrigine. Lacosamide can be administered intravenously as well as orally. The mechanisms of ileus have been suggested; to involve antagonism of the cholinergic, histaminergic, and serotonergic systems. Since lacosamide is not related to these antagonists, it may be one of the helpful options for treating delirium tremens in elderly patients.

Delirium in elderly patients is difficult to treat when complicated by ileus. This report describes three cases of antipsychotic‐induced paralytic ileus successfully managed with lacosamide without severe adverse effects. Lacosamide's pharmacological profile suggests it may be a safe treatment option for delirium tremens in older patients.