Evidence says antipsychotics do not prevent delirium in adults

Evidence says antipsychotics do not prevent delirium in adults

(HealthDay)—Current evidence does not support routine use of haloperidol or second-generation antipsychotics for prevention or treatment of delirium in hospitalized adults, according to two reviews published online Sept. 3 in the Annals of Internal Medicine.

Esther S. Oh, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a to assess the benefits and harms of antipsychotics for preventing delirium in adults. Data were reviewed from 14 randomized controlled trials (RCTs). The researchers found that delirium incidence or duration, hospital length of stay, and mortality did not differ with haloperidol or placebo. Little to no evidence was seen for the effect of haloperidol on cognitive function, delirium severity, inappropriate continuation, and sedation. Second-generation antipsychotics may lower delirium incidence in the postoperative setting, although the evidence is limited.

Roozbeh Nikooie, M.D., also from the Johns Hopkins University School of Medicine, and colleagues conducted a systematic review to examine the benefits and harms of antipsychotics for treating delirium in hospitalized adults. Data were included from 16 RCTs and 10 observational studies. The researchers found that for haloperidol and second-generation antipsychotics versus placebo, there was no difference in sedation status, delirium duration, hospital length of stay, or mortality. For haloperidol versus second-generation antipsychotics, no difference was seen in delirium severity and ; insufficient or no evidence was seen for the comparison of antipsychotics versus placebo.

"With regard to use of antipsychotics for broad treatment of , I believe the findings presented are sufficient to stop this ," writes the author of an accompanying editorial.

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Antipsychotic drugs may not be effective against delirium

More information: Abstract/Full Text - Oh
Abstract/Full Text - Nikooie
Editorial (subscription or payment may be required)
Journal information: Annals of Internal Medicine

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Sep 03, 2019
Patients go into delirium . It is dangerous for the patient and for the staff. There is a balance, and very frequently that balance is giving antipsychotics to patients. Please people, stop thinking you can fine tune every cotton picking thing in the world. There is no perfect world and taking care of patients is one of the least perfect situations in the world when they are in delirium or severely demented. If you want to see for yourself, become a CNA or nurse on a neuro floor. Give all your money away so you don't have a back up financial plan so you have to kiss butt or be financially ruined. Do this 10 years and then tell me if you came up with some stupid study about how it can be done better.

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