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

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.