Abstract
Background
Guidelines suggest limited and cautious use of antipsychotics for treatment of delirium where nonpharmacological interventions have
failed and symptoms remain distressing or dangerous, or both. It is unclear how well these recommendations are supported by current evidence.
Objectives
Our primary objective was to assess the efficacy of antipsychotics versus nonantipsychotics or placebo on the duration of delirium in
hospitalised adults. Our secondary objectives were to compare the efficacy of: 1) antipsychotics versus nonantipsychotics or placebo
on delirium severity and resolution, mortality, hospital length of stay, discharge disposition, health-related quality of life, and adverse
effects; and 2) atypical vs. typical antipsychotics for reducing delirium duration, severity, and resolution, hospital mortality and length
of stay, discharge disposition, health-related quality of life, and adverse effects.
Search methods
We searched MEDLINE, Embase, Cochrane EBM Reviews, CINAHL, Thomson Reuters Web of Science and the Latin American and
Caribbean Health Sciences Literature (LILACS) from their respective inception dates until July 2017. We also searched the Database
of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database, Web of Science ISI Proceedings, and other grey literature.
Selection criteria
We included randomised and quasi-randomised trials comparing 1) antipsychotics to nonantipsychotics or pplacebo and 2) typical to atypical antipsychotics for the treatment of delirium in adult hospitalised (but not critically ill) patients.
Guidelines suggest limited and cautious use of antipsychotics for treatment of delirium where nonpharmacological interventions have
failed and symptoms remain distressing or dangerous, or both. It is unclear how well these recommendations are supported by current evidence.
Objectives
Our primary objective was to assess the efficacy of antipsychotics versus nonantipsychotics or placebo on the duration of delirium in
hospitalised adults. Our secondary objectives were to compare the efficacy of: 1) antipsychotics versus nonantipsychotics or placebo
on delirium severity and resolution, mortality, hospital length of stay, discharge disposition, health-related quality of life, and adverse
effects; and 2) atypical vs. typical antipsychotics for reducing delirium duration, severity, and resolution, hospital mortality and length
of stay, discharge disposition, health-related quality of life, and adverse effects.
Search methods
We searched MEDLINE, Embase, Cochrane EBM Reviews, CINAHL, Thomson Reuters Web of Science and the Latin American and
Caribbean Health Sciences Literature (LILACS) from their respective inception dates until July 2017. We also searched the Database
of Abstracts of Reviews of Effects (DARE), Health Technology Assessment Database, Web of Science ISI Proceedings, and other grey literature.
Selection criteria
We included randomised and quasi-randomised trials comparing 1) antipsychotics to nonantipsychotics or pplacebo and 2) typical to atypical antipsychotics for the treatment of delirium in adult hospitalised (but not critically ill) patients.
| Original language | English |
|---|---|
| Journal | Cochrane Database of Systematic Reviews |
| Volume | 2018 |
| Issue number | 6 |
| DOIs | |
| Publication status | E-pub ahead of print - 18 Jun 2018 |