Antipsychotics for the Prevention and Treatment of Delirium

Project Summary Title and Description

Title
Antipsychotics for the Prevention and Treatment of Delirium
Description
To assess benefits and harms of antipsychotics for the prevention and treatment of delirium in adult patient populations.
Attribution
Johns Hopkins Evidence-based Practice Center
Authors of Report
Karin J. Neufeld, M.D., M.P.H. Dale M. Needham, M.D., Ph.D. Esther S. Oh, M.D., Ph.D. Lisa M. Wilson, Sc.M. Roozbeh Nikooie, M.D. Allen Zhang, B.S. Mounica Koneru, M.B.B.S. Amulya Balagani, M.B.B.S. Sriharsha Singu, M.B.B.S. Louay Aldabain, M.D. Karen A. Robinson, Ph.D.
Methodology description
Systematic Review
PROSPERO
N/A
DOI
10.23970/AHRQEPCCER219
Notes
Available at: https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/delirium-finalreport.pdf PMID: 31509366 Data entered retrospectively into SRDR+ Data includes: Study design, patient population characteristics, location, study year started, funding, intervention characteristics, categorical and continuous outcomes data, risk of bias assessment. Data files can be found available at: https://srdr.s3.amazonaws.com/uploads/11-08-2021/Delirium_Intervention+Data.docx https://srdr.s3.amazonaws.com/uploads/11-08-2021/Delirium_Intervention+Data(1).docx https://srdr.s3.amazonaws.com/uploads/11-08-2021/Delirium_Outcomes_Treatment+of+Delirium+Data.docx https://srdr.s3.amazonaws.com/uploads/11-08-2021/Delirium_Risk+of+Bias.docx https://srdr.s3.amazonaws.com/uploads/11-08-2021/Delirium_Study+and+Participant+Characteristics+Data.docx
Funding Source
Agency for Healthcare Research and Quality

Key Questions

1. Key Question 1. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium? a. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium in persons aged 65 years and older? b. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium in persons with dementia? c. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium in patients in an intensive care unit? d. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium in patients in a post-acute care facility? e. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium in patients in palliative or hospice care? f. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to prevent delirium in patients in postoperative care?
2. Key Question 2. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium? a. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium in persons aged 65 years and older? b. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium in persons with dementia? c. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium in patients in an intensive care unit? d. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium in patients in a post-acute care facility? e. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium in patients in palliative or hospice care? f. What are the benefits and harms of antipsychotics compared with each other, placebo, or non-drug approaches to treat delirium in patients in postoperative care?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Preventing ICU Subsyndromal Delirium Conversion to Delirium With Low-Dose IV Haloperidol: A Double-Blind, Placebo-Controlled Pilot Study.Al-Qadheeb NS; Skrobik Y; Schumaker G; Pacheco MN; Roberts RJ; Ruthazer RR; Devlin JW2016 Mar
Morphine is a reasonable alternative to haloperidol in the treatment of postoperative hyperactive-type delirium after cardiac surgery.Atalan N; Efe Sevim M; Akgun S; Fazliogullari O; Basaran C2013 Oct
A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients.Breitbart W; Marotta R; Platt MM; Weisman H; Derevenco M; Grau C; Corbera K; Raymond S; Lund S; Jacobson P1996 Feb
An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients.Breitbart W; Tremblay A; Gibson C2002 May-Jun
Dexmedetomidine for the Treatment of Hyperactive Delirium Refractory to Haloperidol in Nonintubated ICU Patients: A Nonrandomized Controlled Trial.Carrasco G; Baeza N; Cabre L; Portillo E; Gimeno G; Manzanedo D; Calizaya M2016 Jul
Efficacy and safety of quetiapine in critically ill patients with delirium: a prospective, multicenter, randomized, double-blind, placebo-controlled pilot study.Devlin JW; Roberts RJ; Fong JJ; Skrobik Y; Riker RR; Hill NS; Robbins T; Garpestad E2010 Feb
Comparison of Lurasidone Versus Quetiapine for the Treatment of Delirium in Critically Ill Patients.Fox MA; Elefritz JL; Huang BM; Hunley C2020 Apr
Haloperidol prophylaxis does not prevent postoperative delirium in elderly patients: a randomized, open-label prospective trial.Fukata S; Kawabata Y; Fujisiro K; Katagawa Y; Kuroiwa K; Akiyama H; Terabe Y; Ando M; Kawamura T; Hattori H2014 Dec
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness.Girard TD; Exline MC; Carson SS; Hough CL; Rock P; Gong MN; Douglas IS; Malhotra A; Owens RL; Feinstein DJ; Khan B; Pisani MA; Hyzy RC; Schmidt GA; Schweickert WD; Hite RD; Bowton DL; Masica AL; Thompson JL; Chandrasekhar R; Pun BT; Strength C; Boehm LM; Jackson JC; Pandharipande PP; Brummel NE; Hughes CG; Patel MB; Stollings JL; Bernard GR; Dittus RS; Ely EW2018 Dec 27
Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: the MIND randomized, placebo-controlled trial.Girard TD; Pandharipande PP; Carson SS; Schmidt GA; Wright PE; Canonico AE; Pun BT; Thompson JL; Shintani AK; Meltzer HY; Bernard GR; Dittus RS; Ely EW2010 Feb
Comparative efficacy study of haloperidol, olanzapine and risperidone in delirium.Grover S; Kumar V; Chakrabarti S2011 Oct
Comparative effectiveness of quetiapine and haloperidol in delirium: A single blind randomized controlled study.Grover S; Mahajan S; Chakrabarti S; Avasthi A2016 Sep 22
Early treatment with risperidone for subsyndromal delirium after on-pump cardiac surgery in the elderly: a randomized trial.Hakim SM; Othman AI; Naoum DO2012 May
Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study.Hatta K; Kishi Y; Wada K; Odawara T; Takeuchi T; Shiganami T; Tsuchida K; Oshima Y; Uchimura N; Akaho R; Watanabe A; Taira T; Nishimura K; Hashimoto N; Usui C; Nakamura H2014 Mar
A double-blind trial of risperidone and haloperidol for the treatment of delirium.Han CS; Kim YK2004 Jul-Aug
Treatment for delirium with risperidone: results of a prospective open trial with 10 patients.Horikawa N; Yamazaki T; Miyamoto K; Kurosawa A; Oiso H; Matsumoto F; Nishimura K; Karasawa K; Takamatsu K2003 Jul-Aug
Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial.Hui D; Frisbee-Hume S; Wilson A; Dibaj SS; Nguyen T; De La Cruz M; Walker P; Zhukovsky DS; Delgado-Guay M; Vidal M; Epner D; Reddy A; Tanco K; Williams J; Hall S; Liu D; Hess K; Amin S; Breitbart W; Bruera E2017 Sep 19
Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study.Kalisvaart KJ; de Jonghe JF; Bogaards MJ; Vreeswijk R; Egberts TC; Burger BJ; Eikelenboom P; van Gool WA2005 Oct
Preventing Postoperative Delirium After Major Noncardiac Thoracic Surgery-A Randomized Clinical Trial.Khan BA; Perkins AJ; Campbell NL; Gao S; Khan SH; Wang S; Fuchita M; Weber DJ; Zarzaur BL; Boustani MA; Kesler K2018 Dec
Antipsychotics and dopamine transporter gene polymorphisms in delirium patients.Kim JY; Jung IK; Han C; Cho SH; Kim L; Kim SH; Lee BH; Lee HJ; Kim YK2005 Apr
An open pilot trial of olanzapine for delirium in the Korean population.Kim KS; Pae CU; Chae JH; Bahk WM; Jun T2001 Oct
Treatment of delirium in older adults with quetiapine.Kim KY; Bader GM; Kotlyar V; Gropper D2003 Mar
Risperidone versus olanzapine for the treatment of delirium.Kim SW; Yoo JA; Lee SY; Kim SY; Bae KY; Yang SJ; Kim JM; Shin IS; Yoon JS2010 Jun-Jul
Treatment of delirium with risperidone in cancer patients.Kishi Y; Kato M; Okuyama T; Thurber S2012 Aug
[Comparison of sedation with dexmedetomidine and haloperidol in patients with delirium after femoral neck fractures].Konkayev AK; Bekmagambetova NV2015 Jan-Feb
Administration of olanzapine to prevent postoperative delirium in elderly joint-replacement patients: a randomized, controlled trial.Larsen KA; Kelly SE; Stern TA; Bode RH Jr; Price LL; Hunter DJ; Gulczynski D; Bierbaum BE; Sweeney GA; Hoikala KA; Cotter JJ; Potter AW2010 Sep-Oct
Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study.Lee KU; Won WY; Lee HK; Kweon YS; Lee CT; Pae CU; Bahk WM2005 Nov
An open-label study of quetiapine for delirium.Maneeton B; Maneeton N; Srisurapanont M2007 Oct
Quetiapine versus haloperidol in the treatment of delirium: a double-blind, randomized, controlled trial.Maneeton B; Maneeton N; Srisurapanont M; Chittawatanarat K2013
Risperidone in the treatment of delirium: results from a prospective open-label trial.Mittal D; Jimerson NA; Neely EP; Johnson WD; Kennedy RE; Torres RA; Nasrallah HA2004 May
Editor's Choice-Clinical impact of delirium and antipsychotic therapy: 10-Year experience from a referral coronary care unit.Naksuk N; Thongprayoon C; Park JY; Sharma S; Gaba P; Rosenbaum AN; Peeraphatdit T; Hu TY; Bell MR; Herasevich V; Brady PA; Kapa S; Asirvatham SJ2017 Sep
A pilot trial of quetiapine for the treatment of patients with delirium.Pae CU; Lee SJ; Lee CU; Lee C; Paik IH2004 Mar
Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (Hope-ICU): a randomised, double-blind, placebo-controlled trial.Page VJ; Ely EW; Gates S; Zhao XB; Alce T; Shintani A; Jackson J; Perkins GD; McAuley DF2013 Sep
Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery.Prakanrattana U; Prapaitrakool S2007 Oct
A prospective, open-label, flexible-dose study of quetiapine in the treatment of delirium.Sasaki Y; Matsuyama T; Inoue S; Sunami T; Inoue T; Denda K; Koyama T2003 Nov
Low dose oral haloperidol does not prolong QTc interval in older acutely hospitalised adults: a subanalysis of a randomised double-blind placebo-controlled study.Schrijver EJ; Verstraaten M; van de Ven PM; Bet PM; van Strien AM; de Cock C; Nanayakkara PW2018 Jun
Haloperidol versus placebo for delirium prevention in acutely hospitalised older at risk patients: a multi-centre double-blind randomised controlled clinical trial.Schrijver EJM; de Vries OJ; van de Ven PM; Bet PM; Kamper AM; Diepeveen SHA; van Marum RJ; van Strien AM; Anten S; Lagaay AM; Boelaarts L; Bloemers FW; Kramer MHH; Nanayakkara PWB2018 Jan 1
Olanzapine in the treatment of delirium.Sipahimalani A; Masand PS1998 Sep-Oct
Aripiprazole in the treatment of delirium.Straker DA; Shapiro PA; Muskin PR2006 Sep-Oct
A randomized controlled trial of quetiapine versus placebo in the treatment of delirium.Tahir TA; Eeles E; Karapareddy V; Muthuvelu P; Chapple S; Phillips B; Adyemo T; Farewell D; Bisson JI2010 Nov
Relationship between plasma concentration levels of risperidone and clinical effects in the treatment of delirium.Toda H; Kusumi I; Sasaki Y; Ito K; Koyama T2005 Nov
Haloperidol prophylaxis in critically ill patients with a high risk for delirium.van den Boogaard M; Schoonhoven L; van Achterberg T; van der Hoeven JG; Pickkers P2013 Jan 17
Haloperidol prophylaxis decreases delirium incidence in elderly patients after noncardiac surgery: a randomized controlled trial*.Wang W; Li HL; Wang DX; Zhu X; Li SL; Yao GQ; Chen KS; Gu XE; Zhu SN2012 Mar
Paliperidone in the treatment of delirium: results of a prospective open-label pilot trial.Yoon HK; Kim YK; Han C; Ko YH; Lee HJ; Kwon DY; Kim L2011 Aug
Efficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative Care: A Randomized Clinical Trial.Agar Meera R; Lawlor Peter G; Quinn Stephen; Draper Brian; Caplan Gideon A; Rowett Debra; Sanderson Christine; Hardy Janet; Le Brian; Eckermann Simon; McCaffrey Nicola; Devilee Linda; Fazekas Belinda; Hill Mark; Currow David C2017
Dexmedetomidine versus haloperidol for prevention of delirium during non-invasive mechanical ventilationAbdelgalel EF2016
Comparison of dexmedetomidine or ondansetron with haloperidol for treatment of postoperative delirium in trauma patients admitted to intensive care unit: Randomized controlled trialBakri MH; Ismail EA; Ibrahim A118-23
Haloperidol and risperidone in the treatment of delirium and its subtypesBoettger S; Breitbart W; Passik S2011
Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effectsBoettger S; Breitbart W; Jenewein J2015
Efficacy and safety of antipsychotic medications in the treatment of deliriumCharoenporn V2018
Effect of intravenous haloperidol on the duration of delirium and coma in critically ill patients (hope-ICU)Drinkwater B; Billyard T2014
Olanzapine and haloperidol for senile delirium: A randomized controlled observationHu H; Deng W; Yang H; Liu Y2006
Efficacy of risperidone in the treatment of delirium in elderly patientsIkezawa, K; Canuet, L; Ishii, R; Iwase, M; Teshima, Y; Takeda, M2008
Prophylactic consecutive administration of haloperidol can reduce the occurrence of postoperative delirium in gastrointestinal surgeryKaneko, T; Cai, J; Ishikura, T; Kobayashi, M; Naka, T; Kaibara, N1999
Comparison of the Clinical Efficacy and Safety between Intramuscular Olanzapine and Intramuscular Haloperidol Injection in the Treatment of DeliriumLim, H. K.; Paik, I. H.; Oh, K.; Lee, C. U.; Lee, C.2007
An open trial comparing haloperidol with olanzapine for the treatment of delirium in palliative and hospice center cancer patientsLin, C. J.; Sun, F. J.; Fang, C. K.; Chen, H. W.; Lai, Y. L.2008
Clinical experience of quetiapine in 24 elderly patients with deliriumOmura K; Amano N2003
Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial.van den Boogaard Mark; Slooter Arjen J C; Br├╝ggemann Roger J M; Schoonhoven Lisette; Beishuizen Albertus; Vermeijden J Wytze; Pretorius Danie; de Koning Jan; Simons Koen S; Dennesen Paul J W; Van der Voort Peter H J; Houterman Saskia; van der Hoeven J G; Pickkers Peter; REDUCE Study Investigators; van der Woude Margaretha C. E.; Besselink Anna; Hofstra Lieuwe S; Spronk Peter E; van den Bergh Walter; Donker Dirk W; Fuchs Malaika; Karakus Attila; Koeman M; van Duijnhoven Mirella; Hannink Gerjon2018
Comparison of efficacy of haloperidol and olanzapine in the treatment of delirium.Jain Rajan; Arun Priti; Sidana Ajeet; Sachdev Atul2017 Oct-Dec

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