Use of Olanzapine by Subcutaneous Catheter to Control Refractory Delirium: A Case Report

Introduction: Delirium is the most common neuropsychiatric disorder in elderly patients, with an increase in its presentation at the end of life. Within pharmacological management, haloperidol is considered as the first line, with limited use due to extrapyramidal and cardiovascular effects. Olanzapine is an alternative, without having clear and precise evidence on subcutaneous administration, especially in a palliative setting. Case presentation: A 93-year-old patient with an acute cerebrovascular event, which led to a catastrophic functional decline, who presented as a symptom of hyperactive delirium that was difficult to manage without response to two first lines of management, including haloperidol, in whom control of symptom with subcutaneous olanzapine. Conclusions: Subcutaneous olanzapine is a therapeutic option for the management of delirium in the palliative context, when the goal of care is comfort, and the end of life is imminent.