Antipsychotics Ineffective for Delirium During Hospitalization
No significant effect was found for preventing or treating delirium during hospitalization with antipsychotic medications.
HealthDay News — Antipsychotic medications do not appear to be effective for preventing or treating delirium in adult medical or surgical inpatients, according to a review published online March 23 in the Journal of the American Geriatrics Society.
Karin J. Neufeld, MD, MPH, from Johns Hopkins University in Baltimore, and colleagues conducted a systematic review and meta-analysis to examine the effectiveness of antipsychotic medications in preventing and treating delirium. Data for adult surgical and medical inpatients from 19 studies were reviewed.
The researchers observed no significant effect on delirium incidence in 7 studies that compared antipsychotics with placebo or no treatment for delirium prevention after surgery (odds ratio, 0.56; 95 percent confidence interval, 0.23 to 1.34). Antipsychotic use was not associated with change in duration, severity, or hospital or intensive care unit length of stay, using data from all 19 studies; significant heterogeneity was seen among the studies. There was no correlation with mortality (odds ratio, 0.90; 95 percent confidence interval, 0.62 to 1.29).
"Current evidence does not support the use of antipsychotics for prevention or treatment of delirium," the authors wrote. "Additional methodologically rigorous studies using standardized outcome measures are needed."
One author disclosed financial ties to the medical device industry.
Neufeld KJ, Yue J, Robinson TN, Inouye SK, Needham DM. Antipsychotic Medication for Prevention and Treatment of Delirium in Hospitalized Adults: A Systematic Review and Meta-Analysis. J Am Geriatr Soc. 2016; doi:10.1111/jgs.14076.