Antipsychotics for management of delirium – A systematic review
The existing research on antipsychotics for the treatment of delirium was reviewed. Our systematic review and meta-analysis showed that antipsychotics are not associated with a significant change in duration of delirium, mortality rate or occurrence of adverse events.
Findings: It was found that antipsychotic treatment did not affect duration of delirium, mortality rate, or incidence of adverse events. Treatment with an antipsychotic was associated with a shorter duration of hospital length of stay (i.e. antipsychotic favoured), yet intensive care unit length of stay was found to be shorter with a non-antipsychotic intervention (i.e. control group favoured). The current evidence is poor and insufficient to draw conclusions about the effect of antipsychotic medication on the duration and severity of delirium. These results should be interpreted with caution, as additional studies of improved design must be conducted before the lack of effect of antipsychotics on the aforementioned outcomes can be confirmed.
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About the Project
At times it may be necessary to prescribe medications to treat distressing behavioral disturbances. It is suggested by clinical guidelines and experts that antipsychotics be reserved to manage delirium-associated behavioral disturbances are severe or distressing when non-drug methods fail.
Up to 75% of patients treated for delirium are prescribed antipsychotics, depending on the type of patient and severity of symptoms. Antipsychotics, however, may have significant side effects, particularly in the elderly, including the potential to worsen delirium and increased risk of sudden death.
The efficacy and safety of antipsychotics for delirium has not been clearly delineated, therefore we will conduct a systematic review through The Cochrane Collaboration to determine the efficacy and safety of antipsychotics for the treatment of delirium in hospitalized patients.
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Lisa Burry, BScPharm, PharmD -- Mount Sinai Hospital
Chaim Bell, MD, FRCPC, PhD -- Mount Sinai Hospital
Wesley Ely, MD -- Vanderbilt University
Dean Fergusson, PhD, MHA -- Ottawa Hospital Research Institute
Jay Luxenberg, MD -- University of California San Francisco
Sangeeta Mehta, MD, BSc, FRCP(C) -- Mount Sinai Hospital
Marc Perreault, PharmD, BCPS -- Université de Montréal/McGill University Health Centre
Louise Rose, RN, BN, MN, PhD -- University of Toronto
Knowledge Users and Partners:
Neill Adhikari, MDCM, MSc -- Sunnybrook Health Sciences Centre
Ingrid Egerod, RN, PhD -- University of Copenhagen
José Morais, MD -- Canadian Geriatrics Society
Doug Sellinger, BSP, MALT -- Canadian Society of Hospital Pharmacists
Samir Sinha, MD, DPhil, FRCPC -- Mount Sinai Hospital
Lesley Wiesenfeld, MD, FRCPC -- Mount Sinai Hospital
Camilla Wong, MD, MHSc, FRCPC -- St. Michael's Hospital
Project Contact: Lisa Burry -- email@example.com