Antipsychotics Don't Ease Delirium in These People
These drugs won't prevent or effectively treat the condition, review suggests
By Steven Reinberg
TUESDAY, March 29, 2016 (HealthDay News) -- Antipsychotic medications, such as haloperidol (Haldol) or clozapine (Clozaril), aren't appropriate for preventing or routinely treating delirium in hospitalized patients, a new study suggests.
The researchers reviewed past studies and found that antipsychotic drugs given before surgery didn't prevent delirium. These drugs also didn't make any difference in the course of delirium in medical or surgical patients, the study authors said.
"The American Geriatrics Society guidelines suggest avoiding using these medications as a part of routine care of a patient with delirium," said lead researcher Dr. Karin Neufeld, clinical director of psychiatry at Johns Hopkins Bayview Medical Center in Baltimore.
Delirium causes confused thinking and diminished awareness of the environment, such as time and place. Delirium is often caused by physical or mental illness, such as drug abuse or an electrolyte imbalance. Delirium is usually temporary and reversible.
Antipsychotic drugs are routinely used to treat delirium. But the U.S. Food and Drug Administration hasn't specifically approved their use for treating the condition.
However, antipsychotics can be used for limited periods for treating specific symptoms, such as distressing hallucinations, or "when the patient's life or safety are at risk due to severe agitation," Neufeld said.
Treating delirium without drugs has also been shown to be successful, she added.
"Interventions, such as getting the patient out of bed and engaging in physical activity, can be first-line approaches to treating delirium," Neufeld said. "These non-drug types of treatments have been shown to decrease delirium in hospitalized patients and we should incorporate them into our practices," she suggested.
For the new study, Neufeld and colleagues reviewed data from 19 previously published studies. Seven of the studies looked specifically at preventing delirium after surgery. The studies compared antipsychotics with placebo pills or no treatment. The researchers found antipsychotics didn't reduce the risk of delirium.
Pooling data from all 19 studies that included medical and surgical patients, Neufeld's team found that antipsychotics didn't alter how long patients suffered from delirium. The drugs also didn't reduce the severity of delirium. And giving people antipsychotics didn't change how long a patient stayed in the hospital, or if a patient died, the study authors reported.