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Antipsychotics for preventing delirium in hospitalized adults: A systematic review

Annals of Internal Medicine Oct 06, 2019

Oh ES, Needham DM, Nikooie R, et al. - A total of 14 randomized, controlled trials that contrasted an antipsychotic with placebo or another antipsychotic, and prospective observational studies with a comparison group, were involved in order to carry out a systematic review assessing the advantages and disadvantages of antipsychotics for prevention of delirium in adults. In delirium incidence or duration, hospital length of stay, and mortality, no variations between haloperidol and placebo utilized for delirium prevention were noted. To discover the impact of haloperidol on cognitive function, delirium severity, improper continuation, and sedation, little to no evidence was observed. Limited proof that in the postoperative setting, second-generation antipsychotics could lower delirium incidence was obtained. Little evidence that the short-term use of antipsychotics was related to neurologic harms was noted. In some of the trials, probably serious cardiac effects happened more often with antipsychotic use. Hence, for the prevention of delirium, the results do not support the routine use of haloperidol or second-generation antipsychotics. Moreover, insufficient evidence that second-generation antipsychotics might lower the incidence of delirium in postoperative individuals is there, although more research is required.
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