The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
Antipsychotic medication for prevention and treatment of delirium in hospitalized adults: a systematic review and meta-analysis
Open accessAbstract
Objectives: To evaluate the effectiveness of antipsychotic medications in preventing and treating delirium. Design: Systematic review and meta‐analysis. Setting: PubMed, EMBASE , CINAHL , and ClinicalTrials.gov databases were searched from January 1, 1988, to November 26, 2013. Participants: Adult surgical and medical inpatients. Intervention: Antipsychotic administration for delirium prevention or treatment in randomized controlled trials or cohort studies. Measurements: Two authors independently reviewed all citations, extracted relevant data, and assessed studies for potential bias. Heterogeneity was considered as chi‐square P < .1 or I 2 > 50%. Using a random‐effects model (I 2 > 50%) or a fixed‐effects model (I 2 < 50%), odds ratios ( OR s) were calculated for dichotomous outcomes (delirium incidence and mortality), and mean or standardized mean difference for continuous outcomes (delirium duration, severity, hospital and intensive care unit ( ICU ) length of stay ( LOS )). Sensitivity analyses included postoperative prevention studies only, exclusion of studies with high risk of bias, and typical versus atypical antipsychotics. Results: Screening of 10,877 eligible records identified 19 studies. In seven studies comparing antipsychotics with placebo or no treatment for delirium prevention after surgery, there was no significant effect on delirium incidence ( OR = 0.56, 95% confidence interval ( CI ) = 0.23–1.34, I 2 = 93%). Using data reported from all 19 studies, antipsychotic use was not associated with change in delirium duration, severity, or hospital or ICU LOS , with high heterogeneity among studies. No association with mortality was detected ( OR = 0.90, 95% CI = 0.62–1.29, I 2 = 0%). Conclusion: Current evidence does not support the use of antipsychotics for prevention or treatment of delirium. Additional methodologically rigorous studies using standardized outcome measures are needed.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“In the UK however, detection rates have increased over the past 10 years.281”
From Dementia prevention, intervention, and care: 2020 report of the Lancet Commission (2020) · cites this paper as [281]
Experimental — accuracy not yet measuredIn the citing paper
“While antipsychotics such as risperidone, haloperidol, ziprasidone and olanzapine are sometimes used to manage agitation or psychotic symptoms in delirium, there is a lack of strong evidence to support their use 194 .”
From Mental health care for older adults: recent advances and new directions in clinical practice and research (2022) · cites this paper as [194]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014) · The Lancet · doi:10.1016/s0140-6736(13)60688-1 · Cited by 3,722
Self-citationWitlox, J., Eurelings, L. S. M., de Jonghe, J. F. M., Kalisvaart, K. J., Eikelenboom, P., & van Gool, W. A. (2010) · JAMA · doi:10.1001/jama.2010.1013 · Cited by 1,972
The case of the misleading funnel plot
Lau, J., Ioannidis, J. P. A., Terrin, N., Schmid, C. H., & Olkin, I. (2006) · BMJ · doi:10.1136/bmj.333.7568.597 · Cited by 1,766
One-Year Health Care Costs Associated With Delirium in the Elderly Population
LESLIE, D. L. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.4 · Cited by 1,038
Validation of the Delirium Rating Scale-Revised-98
Trzepacz, P. T., D, D. M. M., Torres, R. A. M., Kanary, K., Norton, J., & Jimerson, N. (2001) · Journal of Neuropsychiatry · doi:10.1176/jnp.13.2.229 · Cited by 957 · cited 2×
“Delirium severity was evaluated using the Delirium Rating Scale (DRS)(10) or the DRS Revised-98.(11) When specific data could not be obtained directly from the publications (n = 4), authors were contacted, with all providing additional statistics.”
MethodAndreasen, N. C., Pressler, M., Nopoulos, P., Miller, D. D., & Ho, B. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.08.040 · Cited by 956
A symptom rating scale for delirium
Trzepacz, P. T., Baker, R. W., & Greenhouse, J. B. (1988) · Psychiatry Research · doi:10.1016/0165-1781(88)90037-6 · Cited by 655
Kalisvaart, K. J., de Jonghe, J. F. M., Bogaards, M. J., Vreeswijk, R., Egberts, T. C. G., Burger, B. J., Eikelenboom, P., & van Gool, W. A. (2005) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53503.x · Cited by 636 · cited 4×
“The current results were consistent with the findings of a meta-analysis(34) that included three RCTs of haloperidol versus placebo.(18,19,23) No association between antipsychotics and prevention of postoperative delirium was demonstrated.”
BackgroundResultInfluential
Cited by
Sorted by citations
Dementia prevention, intervention, and care: 2020 report of the Lancet Commission
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30367-6 · Cited by 10,430
RetractedWilson, J. E., Mart, M. F., Cunningham, C. M., Shehabi, Y., Girard, T. D., MacLullich, A. M. J., Slooter, A. J. C., & Ely, E. W. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-00223-4 · Cited by 1,371
Delirium in Hospitalized Older Adults
Marcantonio, E. R. (2017) · New England Journal of Medicine · doi:10.1056/nejmcp1605501 · Cited by 1,228
Delirium in Older Persons: Advances in Diagnosis and Treatment
Oh, E. S., Fong, T. G., Hshieh, T. T., & Inouye, S. K. (2017) · JAMA · doi:10.1001/jama.2017.12067 · Cited by 926
Self-citationPostoperative delirium: perioperative assessment, risk reduction, and management
Jin, Z., Hu, J., & Ma, D. (2020) · British Journal of Anaesthesia · doi:10.1016/j.bja.2020.06.063 · Cited by 705
Reynolds, C. F., Jeste, D. V., Sachdev, P. S., & Blazer, D. G. (2022) · World Psychiatry · doi:10.1002/wps.20996 · Cited by 465
Aldecoa, C., Bettelli, G., Bilotta, F., Sanders, R. D., Aceto, P., Audisio, R. A., Cherubini, A., Cunningham, C. M., Dąbrowski, W., Forookhi, A., et al. (2023) · European Journal of Anaesthesiology · doi:10.1097/eja.0000000000001876 · Cited by 418
Hughes, C. G., Boncyk, C. S., Culley, D. J., Fleisher, L. A., Leung, J. M., McDonagh, D. L., Gan, T. J., McEvoy, M. D., Miller, T. E., & Workgroup, F. T. P. Q. I. (. 6. (2020) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004641 · Cited by 405
Agar, M. R., Lawlor, P. G., Quinn, S. J., Draper, B., Caplan, G. A., Rowett, D. S., Sanderson, C. R., Hardy, J. R., Le, B. H. C., Eckermann, S. D., et al. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.7491 · Cited by 366
“CIRS score, median (IQR) 24 (21-28) 23 (20-26) 25 (21-29)”
Maldonado, J. R. (2017) · Critical Care Clinics · doi:10.1016/j.ccc.2017.03.013 · Cited by 343
Morandi, A., Piva, S., Ely, E. W., Myatra, S. N., Salluh, J. I., Amare, D., Azoulay, É., Bellelli, G., Csomós, Á., Fan, E., et al. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002640 · Cited by 298
Antipsychotics for Treating Delirium in Hospitalized Adults: A Systematic Review
Nikooie, R., Neufeld, K. J., Oh, E. S., Wilson, L. M., Zhang, A., Robinson, K. A., & Needham, D. M. (2019) · Annals of Internal Medicine · doi:10.7326/m19-1860 · Cited by 246
Self-citationMahanna, E., Schenning, K. J., Eriksson, L. I., Browndyke, J. N., Wright, C. B., Evered, L. A., Scott, D. A., Wang, N. Y., Brown, C. H., Oh, E. S., et al. (2019) · British Journal of Anaesthesia · doi:10.1016/j.bja.2019.07.004 · Cited by 231
Self-citationDelirium in adult cancer patients: ESMO Clinical Practice Guidelines
Bush, S. H., Lawlor, P. G., Ryan, K., Centeno, C., Lucchesi, M., Kanji, S., Siddiqi, N., Morandi, A., Davis, D. H. J., Laurent, M., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy147 · Cited by 197
Pharmacological interventions for the treatment of delirium in critically ill adults
Burry, L. D., Hutton, B., Williamson, D. R., Mehta, S., Adhikari, N. K. J., Cheng, W., Ely, E. W., Egerod, I., Fergusson, D. A., & Rose, L. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011749.pub2 · Cited by 180
Hshieh, T. T., Inouye, S. K., & Oh, E. S. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.10.001 · Cited by 184
Self-citationClinical Assessment and Management of Delirium in the Palliative Care Setting
Bush, S. H., Tierney, S., & Lawlor, P. G. (2017) · Drugs · doi:10.1007/s40265-017-0804-3 · Cited by 161
Wu, Y.-C., Tseng, P.-T., Tu, Y.-K., Hsu, C.-Y., Liang, C.-S., Yeh, T.-C., Chen, T.-Y., Chu, C.-S., Matsuoka, Y. J., Stubbs, B., et al. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2018.4365 · Cited by 148
Hshieh, T. T., Inouye, S. K., & Oh, E. S. (2020) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2019.11.001 · Cited by 153
Self-citationThom, R. P., Levy‐Carrick, N. C., Bui, M. P., & Silbersweig, D. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18070893 · Cited by 141
Chaiwat, O., Chanidnuan, M., Pancharoen, W., Vijitmala, K., Danpornprasert, P., To-adithep, P., & Thanakiattiwibun, C. (2019) · BMC Anesthesiology · doi:10.1186/s12871-019-0694-x · Cited by 149
Thein, M. Z. A., Pereira, J. V., Nitchingham, A., & Caplan, G. A. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01723-4 · Cited by 140
Evaluation of algorithms to identify delirium in administrative claims and drug utilization database
Kim, D. H., Lee, J., Kim, C. A., Huybrechts, K. F., Bateman, B. T., Patorno, E., & Marcantonio, E. R. (2017) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.4226 · Cited by 122
Campbell, A., Axon, D. R., Martin, J. R., Slack, M. K., Mollon, L. E., & Lee, J. K. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1297-6 · Cited by 119
van Velthuijsen, E. L., Zwakhalen, S. M. G., Mulder, W. J., Verhey, F. R. J., & Kempen, G. I. J. M. (2017) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4690 · Cited by 111
“Moreover, two recent systematic reviews have concluded that there is little evidence for the efficacy of antipsychotics in the treatment of delirium and that the available evidence is generally weak or circumstantial (Neufeld et al., 2016; Schrijver et al., 2016).”
BackgroundAntipsychotics for Preventing Delirium in Hospitalized Adults: A Systematic Review
Oh, E. S., Needham, D. M., Nikooie, R., Wilson, L. M., Zhang, A., Robinson, K. A., & Neufeld, K. J. (2019) · Annals of Internal Medicine · doi:10.7326/m19-1859 · Cited by 108
Self-citationWalker, D., Gale, C. P., Lip, G. Y. H., Martín‐Sánchez, F. J., McIntyre, H., Mueller, C. E., Price, S., Sanchís, J. M., Vidán, M. T., Wilkinson, C., et al. (2018) · European Heart Journal Acute Cardiovascular Care · doi:10.1177/2048872618758931 · Cited by 107
Electroencephalography and delirium in the postoperative period
Palanca, B. J. A., Wildes, T. S., Ju, Y. S., Ching, S., & Avidan, M. S. (2017) · British Journal of Anaesthesia · doi:10.1093/bja/aew475 · Cited by 101
Impact on the brain of the inflammatory response to surgery
Saxena, S., & Maze, M. (2018) · La Presse Médicale · doi:10.1016/j.lpm.2018.03.011 · Cited by 104
Managing Delirium and Agitation in the Older Emergency Department Patient: The ADEPT Tool
Shenvi, C., Kennedy, M., Austin, C. A., Wilson, M. P., Gerardi, M. J., & Schneider, S. (2019) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2019.07.023 · Cited by 104
Role of Hospice Care at the End of Life for People With Cancer
Currow, D. C., Agar, M. R., & Phillips, J. L. (2020) · Journal of Clinical Oncology · doi:10.1200/jco.18.02235 · Cited by 109
Recent Advances in Preventing and Managing Postoperative Delirium
Vlisides, P. E., & Avidan, M. S. (2019) · F1000Research · doi:10.12688/f1000research.16780.1 · Cited by 102
Delirium: A Marker of Vulnerability in Older People
Bellelli, G., Brathwaite, J. S., & Mazzola, P. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.626127 · Cited by 101
Delirium in hospitalized older adults
Rieck, K. M., Pagali, S. R., & Miller, D. (2019) · Hospital Practice · doi:10.1080/21548331.2019.1709359 · Cited by 106
“Antipsychotics have no evidence for use in delirium prevention at this time [73].”
BackgroundSleep and Delirium in Adults Who Are Critically Ill
Pisani, M. A., & D’Ambrosio, C. M. (2019) · CHEST Journal · doi:10.1016/j.chest.2019.12.003 · Cited by 89
Drug therapy for delirium in terminally ill adults
Finucane, A., Jones, L., Leurent, B., Sampson, E. L., Stone, P. C., Tookman, A. J., & Candy, B. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004770.pub3 · Cited by 82
“Neufeld 2016 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.”
BackgroundClemmesen, C. G., Lunn, T. H., Kristensen, M. T., Palm, H., & Foss, N. B. (2018) · Anaesthesia · doi:10.1111/anae.14406 · Cited by 79
Herzig, S. J., LaSalvia, M. T., Naidus, E., Rothberg, M. B., Zhou, W., Gurwitz, J. H., & Marcantonio, E. R. (2017) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15066 · Cited by 81
Duprey, M. S., Devlin, J. W., Griffith, J. L., Travison, T. G., Briesacher, B. A., Jones, R., Saczynski, J. S., Schmitt, E. M., Gou, Y., Marcantonio, E. R., et al. (2022) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000005959 · Cited by 75
Self-citationAntipsychotics for treatment of delirium in hospitalised non-ICU patients
Burry, L., Mehta, S., Perreault, M. M., Luxenberg, J. S., Siddiqi, N., Hutton, B., Fergusson, D. A., Bell, C., & Rose, L. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005594.pub3 · Cited by 237
“Our principal finding was consistent with a recent comprehensive review by Neufeld and colleagues (Neufeld 2016).”
BackgroundResultDebate article: Antipsychotic medications are clinically useful for the treatment of delirium
Meagher, D. J., Agar, M. R., & Teodorczuk, A. (2017) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4759 · Cited by 74
“There was considerable heterogeneity among studies, and data from both prevention and treatment studies were combined (Neufeld et al., 2016).”
BackgroundMethodResultInfluentialAging and Post–Intensive Care Syndrome: A Critical Need for Geriatric Psychiatry
Wang, S., Allen, D., Kheir, Y. N., Campbell, N. L., & Khan, B. A. (2017) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2017.05.016 · Cited by 80
Melatonin and Sleep in Preventing Hospitalized Delirium: A Randomized Clinical Trial
Jaiswal, S. J., McCarthy, T. J., Wineinger, N. E., Kang, D. Y., Song, J., Garcia, S., Niekerk, C. J. V., Lu, C. Y., Loeks, M., & Owens, R. L. (2018) · The American Journal of Medicine · doi:10.1016/j.amjmed.2018.04.009 · Cited by 73
Zhang, Q., Gao, F., Zhang, S., Sun, W., & Li, Z. (2019) · Sleep and Breathing · doi:10.1007/s11325-019-01831-5 · Cited by 71
“Moreover, sedatives have certain depressed respiratory action, which may prolong the duration of mechanical ventilation [28, 29] and act as a risk factor for the occurrence of delirium in ICU patients [27].”
BackgroundPsychotic disorders in late life: a narrative review
Tampi, R. R., Young, J. J., Hoq, R., Resnick, K., & Tampi, D. J. (2019) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125319882798 · Cited by 77
Perioperative cognitive protection
Brown, C. H., & Deiner, S. G. (2016) · British Journal of Anaesthesia · doi:10.1093/bja/aew361 · Cited by 72
“In the event of hypoactive delirium, there is no role for antipsychotics to treat or prevent delirium.(98) Benzodiazepines should not be used to treat hyper- or hypo-active delirium and are paradoxically associated with a longer duration of delirium.”
BackgroundDiagnosis, prevention, and management of delirium in the intensive cardiac care unit
Beringola, A. C., Vicent, L., Martín‐Asenjo, R., Puerto, E., Domínguez-Pérez, L., Maruri, R., Moreno, G., Vidán, M. T., Arribas, F., & Bueno, H. (2020) · American Heart Journal · doi:10.1016/j.ahj.2020.11.011 · Cited by 70
Quality of clinical practice guidelines in delirium: a systematic appraisal
Bush, S. H., Marchington, K. L., Agar, M., Davis, D. H. J., Sikora, L., & Tsang, T. W. Y. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013809 · Cited by 59
Top Ten Tips Palliative Care Clinicians Should Know About Psychopharmacology
Riordan, P. A., Briscoe, J. G., Uritsky, T. J., Jones, C. A., & Webb, J. A. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2019.0106 · Cited by 63
Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients
Leung, J. M., Sands, L. P., Chen, N., Ames, C. P., Berven, S., Bozic, K. J., Burch, S., Chou, D., Covinsky, K. E., Deviren, V., et al. (2017) · Anesthesiology · doi:10.1097/aln.0000000000001804 · Cited by 63
Igwe, E. O., Nealon, J. R., Mohammed, M., Hickey, B. A., Chou, K., Chen, K., & Traynor, V. (2020) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2020.110004 · Cited by 62
Limiting sedation for patients with acute respiratory distress syndrome – time to wake up
Shah, F. A., Girard, T. D., & Yende, S. P. (2016) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000382 · Cited by 57
2018 Update on Medical Overuse
Morgan, D. J., Dhruva, S. S., Coon, E. R., Wright, S. M., & Korenstein, D. R. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.5748 · Cited by 57
Delirium in the ICU: how much do we know? A narrative review
Liu, S., Wu, H. Y., Duan, M., Yang, R., Ji, C., Liu, J., & Zhao, H. (2024) · Annals of Medicine · doi:10.1080/07853890.2024.2405072 · Cited by 55
“However, antipsychotics such as haloperidol and ziprasidone have not been shown to reduce the rate of delirium occurrence [72,76,77] or shorten the duration of ICU delirium, and their high incidence of adverse reactions has also been criticized, as confirmed in recent years, by numerous large-scale…”
BackgroundManagement of delirium in Parkinson’s disease
Ebersbach, G., Ip, C. W., Klebe, S., Koschel, J., Lorenzl, S., Schrader, C., Winkler, C., & Franke, C. (2019) · Journal of Neural Transmission · doi:10.1007/s00702-019-01980-7 · Cited by 52
Han, J. H., & Suyama, J. (2018) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2018.05.001 · Cited by 51
Treatment of Delirium During Critical Illness
Prendergast, N. T., Tiberio, P. J., & Girard, T. D. (2021) · Annual Review of Medicine · doi:10.1146/annurev-med-042220-013015 · Cited by 57
Incidence and risk factors of postoperative delirium in elderly surgical patients 2023
Fenta, E., Teshome, D., Kibret, S., Hunie, M., Tiruneh, A., Belete, A., Molla, A., Kassa, B. D., & Geta, K. (2025) · Scientific Reports · doi:10.1038/s41598-024-84554-2 · Cited by 50
Kennedy, M., Koehl, J. L., Shenvi, C., Greenberg, A., Zurek, O., LaMantia, M. A., & Lo, A. X. (2020) · Journal of the American College of Emergency Physicians Open · doi:10.1002/emp2.12110 · Cited by 53
Rivière, J., van der Mast, R. C., Vandenberghe, J. U., & Eede, F. V. D. (2018) · Psychosomatics · doi:10.1016/j.psym.2018.05.011 · Cited by 49
Delirium superimposed on dementia
Morandi, A., & Bellelli, G. (2019) · European Geriatric Medicine · doi:10.1007/s41999-019-00261-6 · Cited by 49
“Indeed, antipsychotic medications have not been proven to prevent delirium or to reduce its duration or severity [75].”
BackgroundRohatgi, N., Weng, Y., Bentley, J., Lansberg, M. G., Shepard, J. W., Mazur, D., Ahuja, N. K., & Hopkins, J. R. (2019) · The American Journal of Medicine · doi:10.1016/j.amjmed.2019.05.035 · Cited by 49
Aiello, G., Cuocina, M., Via, L. L., Messina, S., Attaguile, G. A., Cantarella, G., Sanfilippo, F., & Bernardini, R. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12020435 · Cited by 47
“Due to this risk profile and the lack of evidence of benefits in the prevention and/or treatment of delirium [10], these second-generation antipsychotics have not received significant clinical implementation.”
BackgroundSun, Y., Jiang, M., Ji, Y., Sun, Y., Liu, Y., & Shen, W. (2019) · Drug Design Development and Therapy · doi:10.2147/dddt.s208703 · Cited by 47
“Antipsychotics and anxiolytics were frequently prescribed by clinicians to control associated agitation, which was clearly demonstrated to be lacking efficacy and having a risk of serious side effects.(11,12) Emphasis is therefore placed on the importance of delirium prevention.”
BackgroundRetractedLi, Y., Ma, J., Jin, Y., Li, N., Zheng, R., Mu, W., Wang, J., Jin, H., Chen, J., & Shang, H. C. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012670.pub2 · Cited by 47
“Medications currently used in clinical practice are mainly benzodiazepines and antipsychotic drugs (AGS 2015; Young 2010), but their use is controversial because of the lack of evidence of their eFectiveness and potential for harm (Neufeld 2016; Schrijver 2015; Siddiqi 2016).”
BackgroundDeng, Y., Qin, Z., Wu, Q., Liu, L., Yang, X., Ju, X., Zhang, Y., & Liu, L. (2022) · Drug Design Development and Therapy · doi:10.2147/dddt.s373772 · Cited by 46
“delirium in hospitalized older adults.(30,31) Dexmedetomidine seems to exhibit distinct advantages and is recommended for clinical use because of its prophylactic and direct antidelirium effects.”
BackgroundCurrent Challenges in the Recognition and Management of Delirium Superimposed on Dementia
Nitchingham, A., & Caplan, G. A. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s247957 · Cited by 45
“Antipsychotics do not reduce delirium duration, severity, or length of stay and may cause harm.(100,101) However, expert consensus guides practice and suggests that low-dose antipsychotics may help alleviate distressing symptoms or serve as a chemical restraint when patients are at risk of harming themselves or others.”
BackgroundPolypharmacy and Delirium in Critically Ill Older Adults
Garpestad, E., & Devlin, J. W. (2017) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2017.01.002 · Cited by 49
Delirium Management in the ICU
Reznik, M. E., & Slooter, A. J. C. (2019) · Current Treatment Options in Neurology · doi:10.1007/s11940-019-0599-5 · Cited by 51
Oldham, C. M., Flaherty, J. H., & Maldonado, J. R. (2018) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2018.04.002 · Cited by 44
Korkatti-Puoskari, N., Tiihonen, M., Mora, M. Á. C., Topinková, E., Szczerbińska, K. E., Hartikainen, S. A., & on the Behalf of the EuGMS Task & Finish group on FRIDs (2023) · European Geriatric Medicine · doi:10.1007/s41999-023-00837-3 · Cited by 43
Delirium Monitoring: Yes or No? That Is The Question
Marra, A., Kotfis, K., Hosie, A., MacLullich, A. M. J., Pandharipande, P. P., Ely, E. W., & Pun, B. T. (2019) · American Journal of Critical Care · doi:10.4037/ajcc2019874 · Cited by 43
Waszynski, C., Milner, K. A., Staff, I., & Molony, S. (2018) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.09.018 · Cited by 40
Evidence-Based Practice Guideline: Delirium
Guthrie, P. F., Rayborn, S., & Butcher, H. K. (2018) · Journal of Gerontological Nursing · doi:10.3928/00989134-20180110-04 · Cited by 40
Interdisciplinary care of hip fractures.
Ranhoff, A. H., Saltvedt, I. T., Frihagen, F., Raeder, J. C., Maini, S., & Sletvold, O. (2019) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2019.03.015 · Cited by 40
Zipser, C. M., Deuel, J., Ernst, J., Schubert, M., von Känel, R., & Böttger, S. (2019) · Acta Neurochirurgica · doi:10.1007/s00701-019-03927-z · Cited by 40
Antipsychotics and the Risk of Mortality or Cardiopulmonary Arrest in Hospitalized Adults
Basciotta, M., Zhou, W., Ngo, L. H., Donnino, M. W., Marcantonio, E. R., & Herzig, S. J. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16246 · Cited by 39
“This is important because delirious patients are some of the most likely to be prescribed antipsychotics, despite the limited evidence of any clinical benefit for this indication.(8,29) Although our results may be subject to residual confounding, the persistence of our findings across multiple analytic approaches supp…”
ResultPeri- and postoperative cognitive and consecutive functional problems of elderly patients
Müller, A., Lachmann, G., Wolf, A., Mörgeli, R., Weiß, B., & Spies, C. (2016) · Current Opinion in Critical Care · doi:10.1097/mcc.0000000000000327 · Cited by 38
Defining delirium in idiopathic Parkinson's disease: A systematic review
Lawson, R. A., McDonald, C., & Burn, D. J. (2018) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2018.09.025 · Cited by 40
Olson, M. C., Shill, H. A., Ponce, F. A., & Aslam, S. (2023) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2023.1258190 · Cited by 36
The ABCDEF Bundle for the Respiratory Therapist
Mart, M. F., Brummel, N. E., & Ely, E. W. (2019) · Respiratory Care · doi:10.4187/respcare.07235 · Cited by 39
Delirium in hospitalized patients: Risks and benefits of antipsychotics
Thom, R. P., Mock, C. K., & Teslyar, P. (2017) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.84a.16077 · Cited by 35
Knowns and Unknowns About Delirium in Stroke: A Review
Klimiec, E., Dziedzic, T., Kowalska, K., Słowik, A., & Klimkowicz‐Mrowiec, A. (2016) · Cognitive and Behavioral Neurology · doi:10.1097/wnn.0000000000000110 · Cited by 34
“There is no strong and convincing evidence for the effectiveness of pharmacologic prevention and treatment of delirium (Neufeld et al, 2016).”
BackgroundSpecial Considerations for the Aging Brain and Perioperative Neurocognitive Dysfunction
Rengel, K. F., Pandharipande, P. P., & Hughes, C. G. (2019) · Anesthesiology Clinics · doi:10.1016/j.anclin.2019.04.010 · Cited by 34
Park, Y., Bateman, B. T., Kim, D. H., Hernández–Dı́az, S., Patorno, E., Glynn, R. J., Mogun, H., & Huybrechts, K. F. (2018) · BMJ · doi:10.1136/bmj.k1218 · Cited by 34
Oldham, C. M., Flanagan, N. M., Khan, A., Boukrina, O. V., & Marcantonio, E. R. (2017) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.17030065 · Cited by 34
Correale, M., Altamura, M., Carnevale, R., Tricarico, L., Malerba, S., Gallotta, A. M., Altamura, C., Perrella, M., Biase, M. D., Bellomo, A., et al. (2019) · Heart Failure Reviews · doi:10.1007/s10741-019-09842-w · Cited by 33
“A recent meta-analysis has examined pharmacologic prevention and treatment of delirium [78].”
BackgroundMaeda, I., Ogawa, A., Yoshiuchi, K., Akechi, T., Morita, T., Oyamada, S., Yamaguchi, T., Imai, K., Sakashita, A., Matsumoto, Y., et al. (2020) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2020.09.001 · Cited by 32
FUKATA, S., Kawabata, Y., Fujishiro, K., Kitagawa, Y., Kuroiwa, K., Akiyama, H., Takemura, M., Ando, M., & Hattori, H. (2016) · Surgery Today · doi:10.1007/s00595-016-1441-2 · Cited by 32
D’Angelo, R. G., Rincavage, M., Tata, A. L., Millstein, L. S., Gulati, M. S., Flurie, R. W., & Gonzales, J. P. (2017) · Journal of Intensive Care Medicine · doi:10.1177/0885066616686741 · Cited by 32
Mei, X., Liu, Y., Han, Y.-Q., & Zheng, C. (2023) · World Journal of Psychiatry · doi:10.5498/wjp.v13.i12.973 · Cited by 33
Characterizing and predicting rates of delirium across general hospital settings
McCoy, T. H., Hart, K. L., & Perlis, R. H. (2017) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2017.01.006 · Cited by 32
Pérez‐Ros, P., Martínez‐Arnau, F. M., Baixauli-Alacreu, S., Caballero-Pérez, M., García-Gollarte, J. F., & Tarazona‐Santabalbina, F. J. (2019) · Journal of Alzheimer s Disease · doi:10.3233/jad-190391 · Cited by 30
New perspectives in aspiration community acquired Pneumonia
Rodriguez, A. E., & Restrepo, M. I. (2019) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2019.1663730 · Cited by 30
Pharmacologic interventions for prevention of delirium in hospitalized older people: A meta-analysis
León‐Salas, B., Trujillo‐Martín, M. M., Martı́nez-Castillo, L. P., Garcı́a, J. G., Pérez‐Ros, P., Rivas‐Ruiz, F., & Serrano-Aguilar, P. G. (2020) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2020.104171 · Cited by 29
Delirium Assessment in Older People in Emergency Departments. A Literature Review
Pérez‐Ros, P., & Martínez‐Arnau, F. M. (2019) · Diseases · doi:10.3390/diseases7010014 · Cited by 29
Antipsychotic Treatment of Delirium in Critically Ill Children: A Retrospective Matched Cohort Study
Kishk, O. A., Simone, S. L., Lardieri, A. B., Graciano, A. L., Tumulty, J. A., & Edwards, S. (2019) · The Journal of Pediatric Pharmacology and Therapeutics · doi:10.5863/1551-6776-24.3.204 · Cited by 29
Flaherty, J. H., Yue, J., & Rudolph, J. L. (2017) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2017.03.004 · Cited by 29
“Most also conclude that antipsychotics should be considered first line.(9,16,31,32) Rather than perpetuate this concept by trying to fit the results of less than optimal studies into what currently is being practiced, this section takes a different approach to the available published studies and answers 3 questions by…”
BackgroundResultSelf-citationBui, M. P., Thom, R. P., Hurwitz, S., Levy‐Carrick, N. C., O’Reilly, M., Wilensky, D., Talmasov, D., Blanchfield, B. B., Vaidya, V., Kakoza, R. M., et al. (2018) · Psychosomatics · doi:10.1016/j.psym.2018.07.011 · Cited by 28
Tomlinson, E., Schnitker, L., & Casey, P. (2024) · Drugs & Aging · doi:10.1007/s40266-024-01122-z · Cited by 29
“…ICU (mean age range 39–84 years) settings, which included 16 RCTs (2288 participants), two prospective cohort trials (458 participants) and one historical controlled trial (476 participants), showed that antipsychotic use did not decrease the duration of delirium, length of stay or mortality [23].”
Metadata
- Authors
- Neufeld, K. J., Yue, J., Robinson, T. N., Inouye, S. K., & Needham, D. M.
- Affiliations
- Johns Hopkins University (US)
- Sichuan University (CN)
- University of Colorado Anschutz (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Neufeld, Karin J.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2016-03-23
- Volume
- 64
- Issue
- 4
- Pages
- 705-714
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC4840067
- OpenAlex
- W2310520207
- Cited by
- 505
- References
- 46
- Citations by year
- 2026: 29 · 2025: 39 · 2024: 58 · 2023: 52 · 2022: 41 · 2021: 42 · 2020: 59 · 2019: 65 · 2018: 56 · 2017: 49 · 2016: 15
- FWCI
- 9.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- John A. Hartford Foundation (2009–0079)
- National Institute on Aging (K07AG041835, P01AG031720)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Clinical Neurology › Alcoholism and Thiamine Deficiency
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- antipsychotic drugs, delirium, delirium prevention, delirium management, hospitalized adults, surgical patients, medical inpatients, postoperative delirium, delirium duration, delirium severity, length of hospital stay, mortality, atypical antipsychotics, typical antipsychotics
- MeSH terms
- Adult, Delirium, Hospitalization, Humans, Antipsychotic Agents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
