Study: Antipsychotics Do Not Prevent Delirium

Antipsychotics are not effective in preventing or treating delirium after surgery, according to a new meta-analysis.

To evaluate whether antipsychotic medications are effective post-surgery, the researchers searched for studies on 4 major online databases from January 1, 1988, to November 26, 2013.

Out of the total 10,877 relevant studies, the researchers reviewed 19 studies that included adult surgical and medical inpatients that fit their criteria.

A random-effects model or a fixed-effects model was used to calculate the odds ratios for dichotomous outcomes—including delirium incidence and mortality rates—and mean or standardized mean difference for continuous outcomes—including delirium duration, severity, hospital and intensive care length of stay.

Seven studies that compared antipsychotics with placebo or no treatment reported no significant effect on delirium incidence after surgery.

In addition, when all the data were pooled, antipsychotics did not effect delirium duration, severity, hospital length of stay, or mortality.

“Current evidence does not support the use of antipsychotics for prevention or treatment of delirium,” the researchers concluded. “Additional methodologically rigorous studies using standardized outcome measures are needed.”

—Amanda Balbi

Reference:

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 [published online March 23, 2016]. J Am Geriatr Soc. doi:10.1111/jgs.14076.