Antipsychotic Medications May be Ineffective for Delirium

New research finds that a commonly used drug class to prevent and treat delirium may not make much of a difference.

Delirium is a psychiatric syndrome that is the direct result of a medical problem. Delirium is characterized or defined by a sudden change in mental cognition; that is, the ability to think and pay attention.

Delirium can cause people to become confused, potentially aggressive, agitated, sleepy, and/or inactive. Delirium also is a psychiatric syndrome that is a direct result of a medical problem.

Most often, delirium occurs in the midst of illness during admission to the hospital or after recovery from surgery. Factors that can contribute to delirium include:

  • acute illness;
  • infection;
  • immobilization (not being able to get out of bed);
  • medications;
  • underlying cognitive problems such as dementia.

Currently, a recommended care plan for someone with recent onset delirium is supportive therapy and pharmacological management.

Supportive care includes reorientation techniques, careful diet and nutrition supplementation, sensory corrections (hearing aids and eyeglasses), and close physical attention to prevent falls or accidents.

Pharmacological therapy often includes the use of neuroleptics such as haloperidol, a high-potency antipsychotic, or risperidone a new antipsychotic with fewer side effects.

In the new review, researchers examined data from 19 different studies that included several thousand hospitalized patients.

They reported that, when looking at all the causes of delirium, antipsychotic medications (treatments used for certain mental health conditions) did not lessen the number of new cases of delirium, and that using antipsychotic medication may not make much difference to the duration, severity, hospital length of stay, or mortality associated with delirium.

The researchers caution, however, that their findings may not cover particular situations where antipsychotics might prove useful for delirium treatment. More studies are needed in this area, say researchers.

Source: American Geriatrics Society
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