Delirium and a History of Alcohol Dependence – What is the Diagnosis?

Abstract: Delirium is not a well-known adverse effect of Vivitrol. This report describes a rare case of delirium involving visual hallucinations and grandiose delusions associated with Vivitrol use that resolved after about 72 hours of being stabilized with lorazepam. Although the mechanism by which Vivitrol induces delirium remains unclear, it is important to understand the potential emergence of delirium associated with Vivitrol. Clinicians should be cognizant of this connection, as a misdiagnosis can lead to prolonged hospitalization, increased financial burden on the patient, and long-term cognitive decline. Other cases have found that there may be an association between naltrexone and visual hallucinations. Perhaps further studies can look for a connection between other naltrexone formulations inducing delirium, as naltrexone comes in oral pills as well (O-NTX). Future studies should be done to understand potential psychotic symptoms associated with naltrexone use, comparing different formulations, and determining their risk of delirium or psychosis. This would help aid the clinician in choosing the right formulation of naltrexone to help with alcohol dependency without inducing delirium.Short Description: Delirium is a clinical syndrome that is described as a disturbed state of consciousness that is acute, transient and associated with multiple causes. Vivitrol is the extended-release intramuscular formulation of Naltrexone that works by antagonizing the mu-opioid receptor to treat alcohol and opioid dependence. In this case report, we will dive into the importance of understanding the effects of Vivitrol and its use in alcohol dependence, as well as how it can cause delirium.Name of Sponsoring Organization(s):