Acute Delirium Induced by Carvedilol: A Case Report

Acute delirium has been reported associated with ? - blocker treatment, including propranolol, atenolol, and metoprolol. We report the first reported case of acute onset of acute delirium in a patient treated with carvedilol with complete reversal after treatment withdrawal. The patient was hospitalized for an acute coronary syndrome with left ventricular systolic dysfunction, treated with percutaneous coronary intervention. He developed acute delirium shortly after starting carvedilol on his third hospital day. Other causes of delirium were excluded, and the delirium resolved within 24 hours of carvedilol discontinuation. Carvedilol is an ? 1 - and ? -adrenergic antagonist with moderate lipid solubility that is eliminated by hepatic metabolism. Given the moderate lipophilicity, carvedilol could certainly penetrate the central nervous system. Our case suggests that carvedilol should be considered among the medications that may cause acute organic brain syndrome. doi: http://dx.doi.org/10.4021/jmc1523w