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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.
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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]
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“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.”
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Items 101–200 of 504
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Antipsychotics for the Prevention and Treatment of Delirium
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“Although not specifically targeting populations receiving palliative care, recent systematic reviews in heterogeneous populations do not support antipsychotic use in hospitalized patients with delirium.[19, 20]”
BackgroundHosie, A., Agar, M. R., Lobb, E. A., Davidson, P. M., & Phillips, J. L. (2017) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.07.007 · Cited by 23
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“118 Other (private rooms, service-wide, hospice, prison, school, telehealth) 26 (6) 13 (9) 13 (4) 0.”
A retrospective analysis of the effectiveness of antipsychotics in the treatment of ICU delirium
Weaver, C., Kane‐Gill, S. L., Gunn, S. R., Kirisci, L., & Smithburger, P. L. (2017) · Journal of Critical Care · doi:10.1016/j.jcrc.2017.05.034 · Cited by 21
“Additionally, several studies have demonstrated that antipsychotics are ineffective for the treatment of ICU delirium [18,19,29,30,36] and recent systematic reviews and meta-analyses concluded that the use of antipsychotics has no effect on delirium incidence, delirium duration, delirium severity, hospital and ICU LOS…”
ResultValidation of an automated delirium prediction model (DElirium MOdel (DEMO)): an observational study
Gonzalvo, C. M., de Wit, H. A. J. M., van Oijen, B. P. C., Deben, D. S., Hurkens, K. P. G. M., Mulder, W. J., Janknegt, R., Schols, J. M. G. A., Verhey, F. R. J., Winkens, B., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016654 · Cited by 21
Pozzi, C., Lanzoni, A., Lucchi, E., Salimbeni, I., Vreese, L. P. D., Bellelli, G., Fabbo, A., & Morandi, A. (2019) · Aging Clinical and Experimental Research · doi:10.1007/s40520-019-01422-0 · Cited by 21
Sedation and Delirium in the Intensive Care Unit—A Practice-Based Approach
Wong, I., Suhitharan, T., Loh, S. C. H., Ng, S. Y., Murfin, B. R., & Shehabi, Y. (2020) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmed.sg.202013 · Cited by 19
Epidemiology, Mechanisms, Diagnosis, and Treatment of Delirium: A Narrative Review
Ospina, J. P., King, F., Madva, E. N., & Celano, C. M. (2018) · Clinical Medicine and Therapeutics · doi:10.24983/scitemed.cmt.2018.00085 · Cited by 20
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Research in Review: Advancing Critical Care Practice
Bridges, E. J., McNeill, M. M., & Munro, N. (2016) · American Journal of Critical Care · doi:10.4037/ajcc2017609 · Cited by 27
Lawlor, P. G., McNamara-Kilian, M., MacDonald, A. R., Momoli, F., Tierney, S., Lacaze-Masmonteil, N., Dasgupta, M., Agar, M. R., Pereira, J. L., Currow, D. C., et al. (2020) · BMC Palliative Care · doi:10.1186/s12904-020-00669-z · Cited by 20
The impact of frailty on in-hospital complications in elderly patients with acute coronary syndrome
Nowak, W., Kowalik, I., Nowicki, M. M., Cichocki, T., & Stępińska, J. (2023) · 老年心脏病学杂志：英文版 · doi:10.26599/1671-5411.2023.03.003 · Cited by 19
Wang, Q., 四川大学华西医院国家老年医学临床研究中心老年医学科, 生., Zhang, X., Guo, Y.-J., Pang, Y., Li, J., Zhao, Y., Wei, J.-F., Zhu, B.-T., Tang, J.-X., et al. (2023) · 动物学研究 · doi:10.24272/j.issn.2095-8137.2022.473 · Cited by 23
“The administration of antipsychotic medication for the treatment of delirium in hospitalized patients does not result in noticeable improvements, while nonpharmacological interventions have become commonly used in clinical practice to produce substantial benefits by targeting multiple risk factors associated with deli…”
Self-citationHov, K. R., Neerland, B. E., Undseth, Ø., Wyller, V. B., MacLullich, A. M. J., Qvigstad, E., Skovlund, E., & Wyller, T. B. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5098 · Cited by 19
Mokhtari, M., Farasatinasab, M., Machian, M. J., Yaseri, M., Ghorbani, M., Hashemi, S. M. R., Nikoobakht, M., Golchin, N., Mohammadi, G., & Sistanizad, M. (2020) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-019-02802-1 · Cited by 19
Shenvi, C., Wilson, M., Aldai, A., Pepper, D., & Gerardi, M. J. (2019) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2019.1.39262 · Cited by 22
Weidmann, A. E., Proppé, G. B., Matthíasdóttir, R., Tadić, I., Gunnarsson, P., & Jónsdóttir, F. (2025) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-024-01861-4 · Cited by 18
“A meta-analysis published in 2016, concluded that there is insufficient evidence to support the routine use of antipsychotics to prevent and treat delirium with a call for more rigorous well-powered randomized-controlled trials (RCTs) in high-risk populations [71].”
Pilot Study of Lemborexant for Insomnia in Cancer Patients with Delirium
Terada, T., Hirayama, T., Sadahiro, R., Wada, S., Nakahara, R., & Matsuoka, H. (2022) · Journal of Palliative Medicine · doi:10.1089/jpm.2021.0509 · Cited by 18
“To minimize the effect of decreasing delirium over time, we matched the duration of drug administration for delirium reported in previous studies.(14) PRO was classified as effective if the patient made statements such as ‘‘I slept well.”
MethodBush, S. H., Skinner, E., Lawlor, P. G., Dhuper, M., Grassau, P. A., Pereira, J. L., MacDonald, A. R., Parsons, H. A., & Kabir, M. (2022) · BMC Palliative Care · doi:10.1186/s12904-022-01010-6 · Cited by 18
“Publication of these trial results together with the findings of a systematic review and meta-analysis, which concluded that the use of antipsychotics was not associated with a change in delirium severity or duration [23], prompted a re-evaluation of the symptomatic management of delirium with antipsychotics in pallia…”
ResultGlass, O., Hermida, A. P., Hershenberg, R., & Schwartz, A. C. (2020) · Current Psychiatry Reports · doi:10.1007/s11920-020-01147-2 · Cited by 19
Matsuda, Y., Tanimukai, H., Inoue, S., Inada, S., Sugano, K., Hasuo, H., Yoshimura, M., Wada, S., Dotani, C., Adachi, H., et al. (2020) · Japanese Journal of Clinical Oncology · doi:10.1093/jjco/hyaa003 · Cited by 18
“Neufeld conducted a SR and meta-analysis (MA) to evaluate the use of antipsychotics for preventing and treating delirium in non-cancer patients (29).”
MethodPost-Operative Delirium in Elderly Patients: A Narrative Review
Smirnov, A., Semionov, M., Yasinski, V., Binyamin, Y., Zlotnik, A. A., & Frank, D. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262311314 · Cited by 17
“Similarly, a Cochrane meta-analysis conducted by Neufeld et al. concluded that the type of anesthesia is not a strong independent predictor of POD compared with other perioperative factors, such as surgical stress, patient frailty, or intraoperative hypotension [24].”
Silva, L. O. J. E., Stanich, J. A., Jeffery, M. M., Lindroth, H. L., Miller, D., Campbell, R. L., Rabinstein, A. A., Pignolo, R. J., & Bellolio, F. (2021) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2021.12.032 · Cited by 17
Diagnosis of delirium: a practical approach
Alexander, S. K., & Needham, E. (2022) · Practical Neurology · doi:10.1136/pn-2022-003373 · Cited by 17
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“55,56 Thus, although it may be still considered a standard of care in most care settings for the treatment of delirium symptoms such as agitation and psychosis, haloperidol and other antipsychotics should not be employed for routine use in the treatment of POD.”
Melatonin intervention to prevent delirium in hospitalized patients: A meta-analysis
You, W., Fan, X., Cheng, L., Nie, C., Chen, Y., & Wang, X. (2022) · World Journal of Clinical Cases · doi:10.12998/wjcc.v10.i12.3773 · Cited by 16
Co-ultraPEALut: Role in Preclinical and Clinical Delirium Manifestations
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DELIRIUM EN EL ADULTO MAYOR HOSPITALIZADO
Tobar, E. A., & Álvarez, E. (2020) · Revista Médica Clínica Las Condes · doi:10.1016/j.rmclc.2019.11.008 · Cited by 22
Effects of perioperative interventions for preventing postoperative delirium
Li, X., Wang, Y., Liu, J., Xiong, Y., Chen, S., Han, J., Xie, W., & Wu, Q. (2021) · Medicine · doi:10.1097/md.0000000000026662 · Cited by 17
Li, T., Dong, T., Cui, Y., Meng, X., & Dai, Z. (2022) · Frontiers in Surgery · doi:10.3389/fsurg.2022.937293 · Cited by 19
Lange, P. W., Clayton‐Chubb, D., Watson, R., & Maier, A. B. (2020) · Internal Medicine Journal · doi:10.1111/imj.14763 · Cited by 16
Delirium Among Adults Undergoing Solid Organ Transplantation
Chu, N. M., Segev, D. L., & McAdams‐DeMarco, M. (2021) · Current Transplantation Reports · doi:10.1007/s40472-021-00326-1 · Cited by 16
Jing, G., Xie, Q., Tong, J., Liu, L., Xue, J., & Si, L. (2022) · Orthopaedic Surgery · doi:10.1111/os.13244 · Cited by 15
“Two recent meta analyses showed that haloperidol or second-generation antipsychotics for the prevention of delirium did not shorten length of stay in hospital and also had no effect on cognitive function and delirium severity.(10) However, studies have shown that perioperative delirium is preventable in 30%–40% of the…”
ResultBrain Prehabilitation for Oncologic Surgery
Daksla, N., Nguyen, V. T., Jin, Z., & Bergese, S. D. (2022) · Current Oncology Reports · doi:10.1007/s11912-022-01312-1 · Cited by 15
Cognitive disorders in advanced Parkinson’s disease: challenges in the diagnosis of delirium
Daniels, C., Rodríguez-Antigüedad, J., Jentschke, E., Kulisevsky, J., & Volkmann, J. (2024) · Neurological Research and Practice · doi:10.1186/s42466-024-00309-4 · Cited by 15
“No studies have evaluated specific interventions to prevent or treat delirium in PD and current guidelines are primarily based on clinical experience [26, 87, 88].”
BackgroundDevlin, J. W., Smithburger, P. L., Kane, J. M., Fraser, G. L., & Skrobik, Y. K. (2016) · Critical Care Medicine · doi:10.1097/ccm.0000000000002103 · Cited by 15
“Although the current published evidence supporting the use of antipsychotics for delirium treatment in hospitalized patients remains weak (16), other pharmacological alternatives for psychosis or delirium management are sparse (17).”
BackgroundThanapluetiwong, S., Ruangritchankul, S., Sriwannopas, O., Chansirikarnjana, S., Ittasakul, P., Ngamkala, T., Sukumalin, L., Charernwat, P., Saranburut, K., & Assavapokee, T. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02160-7 · Cited by 14
Use of antipsychotic and sedative medications in older patients in the emergency department
Kennedy, M., Koehl, J. L., Gao, J., Ciampa, K. A., Hayes, B. D., & Camargo, C. A. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17590 · Cited by 15
“Although considered first line for pharmacologic treatment of delirium, a meta-analysis of 12 randomized controlled trials found that among hospitalized adults, administration of antipsychotic agents to treat delirium does not reduce the duration or severity of delirium, hospital length of stay, or mortality.(37) It i…”
BackgroundPrevention of Delirium in Older Adults With Dementia: A Systematic Literature Review
Schnitker, L., Nović, A., Arendts, G., Carpenter, C. R., LoGiudice, D., Caplan, G. A., Fick, D. M., & Beattie, E. (2020) · Journal of Gerontological Nursing · doi:10.3928/00989134-20200820-02 · Cited by 16
Antipsychotics and Lorazepam During Delirium: Are We Harming Older Patients? A Real-Life Data Study
Egberts, A., Alan, H., Ziere, G. J., & Mattace-Raso, F. U. S. (2020) · Drugs & Aging · doi:10.1007/s40266-020-00813-7 · Cited by 15
From Bench to Bedside: New Frontiers in Understanding and Treating Postoperative Delirium
Monge, K. M., Shapiro, A. L. B., Coughlan, C. M., Mungo, B., Schulick, R. D., Pratap, A., Kovacs, E. J., & Idrovo, J. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14238418 · Cited by 19
“These interventions often fail to address the underlying pathophysiology and have shown limited efficacy in preventing or treating postoperative delirium [14].”
Delir – ein evidenzbasierter Überblick
Spies, M., Frey, R., Friedrich, M., Kasper, S. F., & dinger-Melich, P. B. (2019) · Wiener klinische Wochenschrift Education · doi:10.1007/s11812-019-00093-1 · Cited by 14
Treatment Effects in Randomized and Nonrandomized Studies of Pharmacological Interventions
Salcher‐Konrad, M., Nguyen, M., Savović, J., Higgins, J. P. T., & Naci, H. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.36230 · Cited by 15
Longitudinal Trends and Variation in Antipsychotic Use in Older Adults After Cardiac Surgery
Kim, D. H., Mahesri, M., Bateman, B. T., Huybrechts, K. F., Inouye, S. K., Marcantonio, E. R., Herzig, S. J., Ely, E. W., Pisani, M. A., Levin, R., et al. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15418 · Cited by 15
“The steep increase in quetiapine use and consistently high rate of potentially excessive dosing of haloperidol are worrisome, particularly in light of recent guidelines highlighting the lack of consistent evidence of the benefit of APMs for delirium and their potential harm.(7,38) One in 8 treated individuals received…”
BackgroundSelf-citationDelirium in Cardiac Intensive Care Unit
Pagad, S., Somagutta, M. K. R., May, V., Arnold, A. A., Nanthakumaran, S., Sridharan, S., & Malik, B. H. (2020) · Cureus · doi:10.7759/cureus.10096 · Cited by 14
“A large meta-analysis study comparing antipsychotics to placebo or no interventions reported no significant antipsychotics effect on delirium incidence (OR = 0.56, 0.23-1.34) [37].”
InfluentialHeterogeneity in design and analysis of ICU delirium randomized trials: a systematic review
Colantuoni, E., Koneru, M., Akhlaghi, N., Li, X., Hashem, M. D., Dinglas, V. D., Neufeld, K. J., Harhay, M. O., & Needham, D. M. (2021) · Trials · doi:10.1186/s13063-021-05299-1 · Cited by 13
Self-citationWang, C., & Zhou, L. (2021) · Asian Journal of Surgery · doi:10.1016/j.asjsur.2021.04.041 · Cited by 14
Olanzapine for the treatment of ICU delirium: a systematic review and meta-analysis
Liu, S., Liu, S., Gao, K., Wu, G. Z., Zu, G., & Liu, J. (2023) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253231152113 · Cited by 15
Engstrom, K., Mattson, A. E., Mara, K. C., Silva, L. O. J. E., Bellolio, F., Jeffery, M. M., Stanich, J. A., & Brown, C. S. (2023) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2023.02.032 · Cited by 13
Psychopharmakotherapie bei Demenz und Delir
Hewer, W., & Thomas, C. (2017) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-016-1176-0 · Cited by 13
“deutliche Unterschiede: Während einige Leitlinien und Konsensuspapiere eine Behandlung mit Psychopharmaka nur dann für gerechtfertigt halten, wennnichtmedikamentöse Strategien mit strikter Konsequenz ausgeschöpft wurden [26, 27, 31, 32], folgen andere zwar auch diesem Prinzip, setzen aber die Schwelle für den Einsatz…”
Valproic Acid in the Management of Delirium
Fernandez, C., & Davis, M. P. (2021) · American Journal of Hospice and Palliative Medicine® · doi:10.1177/10499091211038371 · Cited by 13
“While evidence supports preventive strategies to decrease the incidence of delirium,(3) the evidence for managing agitation in delirium with commonly used antipsychotics and benzodiazepines is disappointing.(4,5) Two recent systematic reviews of randomized controlled trials (RCT) and observational studies evaluated th…”
BackgroundKurisu, K., Inada, S., Maeda, I., Ogawa, A., Iwase, S., Akechi, T., Morita, T., Oyamada, S., Yamaguchi, T., Imai, K., et al. (2021) · Palliative & Supportive Care · doi:10.1017/s1478951521001565 · Cited by 13
“Although the effectiveness of antipsychotics for delirium remains unclear (Neufeld et al., 2016; Burry et al., 2018), short-term use of small-doses of antipsychotics may be considered only for patients with severe distress or risk of harming themselves or others [American Geriatrics Society Expert Panel on Postoperati…”
BackgroundThe use of clonidine in elderly patients with delirium; pharmacokinetics and hemodynamic responses
Hov, K. R., Neerland, B. E., Andersen, A. M., Undseth, Ø., Wyller, V. B., MacLullich, A. M. J., Skovlund, E., Qvigstad, E., & Wyller, T. B. (2018) · BMC Pharmacology and Toxicology · doi:10.1186/s40360-018-0218-1 · Cited by 13
Shim, E., Noh, H. L., Lee, K.-M., Hwang, H., Son, K., Jung, D., Kim, W., Kong, S., Suh, Y., Lee, H., et al. (2019) · Supportive Care in Cancer · doi:10.1007/s00520-018-4604-4 · Cited by 13
Garcez, F. B., Avelino‐Silva, T. J., de Castro, R. E. V., & Inouye, S. K. (2021) · Geriatrics Gerontology and Aging · doi:10.53886/gga.e0210032 · Cited by 13
Self-citationToth, J. M., Jadhav, S., Holmes, H. M., & Sharma, M. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-02971-2 · Cited by 12
“APs have not been found to help prevent or treat delirium in inpatients and are associated with falls [21, 22].”
Adverse Events Associated with Antipsychotic Use in Hospitalized Older Adults After Cardiac Surgery
Kim, D. H., Huybrechts, K. F., Patorno, E., Marcantonio, E. R., Park, Y., Levin, R., Abdurrob, A., & Bateman, B. T. (2017) · Journal of the American Geriatrics Society · doi:10.1111/jgs.14768 · Cited by 12
Hosie, A., Phillips, J. L., Lam, L. T.-M., Kochovska, S., Noble, B., Brassil, M., Kurrle, S. E., Cumming, A., Caplan, G. A., Chye, R., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026177 · Cited by 12
Current Trends for Delirium Screening within the Emergency Department
Saviano, A., Zanza, C., Longhitano, Y., Ojetti, V., Franceschi, F., Bellou, A., Voza, A., Ceresa, I. F., & Savioli, G. (2023) · Medicina · doi:10.3390/medicina59091634 · Cited by 11
“Furthermore, to manage symptoms of delirium, pharmacological [48,49] and non-pharmacological treat-ment [50] can be used [47].”
A Lethal Combination of Delirium and Overcrowding in the Emergency Department
Bonfichi, A., Ceresa, I. F., Piccioni, A., Zanza, C., Longhitano, Y., Boudi, Z., Esposito, C., & Savioli, G. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12206587 · Cited by 11
“Although antipsychotics may help manage symptoms of delirium or agitation, meta-analyses do not demonstrate any benefit in terms of outcomes such as symptom duration, severity, length of hospital stay, placement location, or mortality [106].”
BackgroundTomlinson, E., Rawson, H. A., Manias, E., Phillips, N. M., Darzins, P. J., & Hutchinson, A. M. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-047247 · Cited by 11
Evolving Clinical Management of Postoperative Delirium: A Narrative Review
Ahmadzadeh, S., Duplechin, D. P., Haynes, A. T., Hollander, A. V., Rieger, R., Baptiste, C. J., Varrassi, G., Shekoohi, S., & Kaye, A. D. (2025) · Cureus · doi:10.7759/cureus.92927 · Cited by 10
“Once delirium develops, first-line management focuses on identifying reversible medical triggers, optimizing analgesia, and providing a low-stimulation environment; pharmacological agents are reserved for severe agitation that threatens patient or staff safety [8].”
Dalton, T., Snyder, L. D., Buckley, E. B., & Smith, P. J. (2022) · Experimental Gerontology · doi:10.1016/j.exger.2022.111781 · Cited by 10
Tarrell, A., Giles, L. L., Smith, B., Traube, C., & Watt, K. (2023) · Journal of Perinatology · doi:10.1038/s41372-023-01767-5 · Cited by 10
“However, more recent reports have challenged the use of antipsychotics for prevention and treatment of delirium in adults as they do not seem to impact the incidence, severity, or duration of delirium [41, 51 – 53].”
Marcantonio, A., Pace, M. M., Brabeck, D., Nault, K., Trzaskos, A., & Anderson, R. L. (2017) · JBJS Reviews · doi:10.2106/jbjs.rvw.17.00026 · Cited by 10
Management of Very Old Patients in Intensive Care Units
Ding, X., Lian, H., & Wang, X. (2021) · Aging and Disease · doi:10.14336/ad.2020.0914 · Cited by 13
Trends in use of antipsychotics and psychoactive drugs in older patients after major surgery
Kim, D. H., Lee, H., Pawar, A. M., Lee, S. B., Park, C. M., Levin, R., Metzger, E. D., Bateman, B. T., Ely, E. W., Pandharipande, P. P., et al. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18580 · Cited by 10
“6 In particular, the role of quetiapine is uncertain given its anticholinergic properties, which may cause or worsen delirium 40 and sedation.”
BackgroundSelf-citationDurlach, M., Khoury, M. C., Donato, C. L., Pérez, E. A., Iezzi, N. H., López, R., & Echavarría, G. L. (2023) · Medicina Clínica · doi:10.1016/j.medcli.2023.05.012 · Cited by 9
Wu, Z.-B., Jiang, Y., Li, S., & Li, A. (2025) · PLoS ONE · doi:10.1371/journal.pone.0319297 · Cited by 10
“Despite its significant impact, pharmacologic treatment options for delirium remain limited [11].”
Arbabi, M., Ziaei, E., Amini, B., Ghadimi, H., Rashidi, F., Shohanizad, N., Moradi, S., Beikmarzehei, A., Hasanzadeh, A., & Parsaei, A. (2022) · BMC Anesthesiology · doi:10.1186/s12871-022-01690-w · Cited by 9
Kim, D. H., Lee, S. B., Park, C. M., Levin, R., Metzger, E. D., Bateman, B. T., Ely, E. W., Pandharipande, P. P., Pisani, M. A., Jones, R. N., et al. (2023) · Annals of Internal Medicine · doi:10.7326/m22-3021 · Cited by 9
Self-citationIbrahimi, B., Böettger, S., Schubert, M., Béttex, D., & Rudiger, A. (2020) · Palliative & Supportive Care · doi:10.1017/s1478951520000231 · Cited by 9
“Further, previous reviews supported the use of antipsychotics, whereas a later review disapproved of their use (Barbateskovic et al., 2016; Kishi et al., 2016; Neufeld et al., 2016; Burry et al., 2018; Nikooie et al., 2019; Riviere et al., 2019).”
ResultDelirium Prevention in Postcardiac Surgical Critical Care
Sanjanwala, R., Stoppe, C., Khoynezhad, A. B., Hill, A., Engelman, D. T., & Arora, R. C. (2020) · Critical Care Clinics · doi:10.1016/j.ccc.2020.06.001 · Cited by 9
A scientometric study of publications on delirium from 2001 to 2020
Grover, S., & Gupta, B. M. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102889 · Cited by 9
Isaev, R. I., Ткачева, О. Н., Рунихина, Н. К., Шарашкина, Н. В., Mkhitaryan, E. A., Cherdak, M. A., Маневич, Т. М., & Yakhno, N. N. (2022) · Russian Journal of Geriatric Medicine · doi:10.37586/2686-8636-1-2022-17-23 · Cited by 8
Othman, S. M. A., Aziz, M. A. A., Sriwayyapram, C., & Xu, Q. (2024) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-024-03173-0 · Cited by 8
de la Varga-Martínez, O., Badenes, R., Gordaliza, C., Manso, S. D. M., Castillo, G., Aragon, C. A., Castro, M. F., dos Santos, A. C. A., Herrero, R. L., Pérez, R. N., et al. (2025) · Revista Española de Anestesiología y Reanimación (English Edition) · doi:10.1016/j.redare.2025.501805 · Cited by 8
Placebo might be superior to antipsychotics in management of delirium in the palliative care setting
Böettger, S., & Jenewein, J. (2017) · BMJ Evidence-Based Medicine · doi:10.1136/ebmed-2017-110723 · Cited by 8
Conti, F., Consonni, D., Damanti, S., Nobili, A., Pasina, L., Mannucci, P. M., Cesari, M., & Rossi, P. D. (2020) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.08.004 · Cited by 8
Le syndrome confusionnel en gériatrie
Maeker, É., & Maeker-Poquet, B. (2021) · NPG. Neurologie, psychiatrie, gériatrie/NPG · doi:10.1016/j.npg.2020.12.002 · Cited by 8
Nakamura, T., Yoshizawa, T., Toya, R., Terasawa, M., Takahashi, K., Kitazawa, K., Suzuki, K., Sasayama, D., & Washizuka, S. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.06.019 · Cited by 8
Drugs, delirium, and ethics at the end of life
Thomas, J. M., Alici, Y., BREITBART, W. S., Bruera, E. D., Blackler, L., & Sulmasy, D. P. (2024) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18766 · Cited by 8
Neurological Complications in Cardiac Surgery
Gerster, P. A., Klesse, A., Chang, J. Y., Erb, J. M., & Goettel, N. (2019) · Current anesthesiology reports · doi:10.1007/s40140-019-00344-x · Cited by 8
Can Cognitive Training Improve Perioperative Brain Health?
Vlisides, P. E., Keage, H. A. D., & Lampit, A. (2020) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000004543 · Cited by 8
The Australian Delirium Clinical Care Standard: not just another brick in the wall
Teodorczuk, A., Reade, M. C., & Graham, F. A. (2023) · Age and Ageing · doi:10.1093/ageing/afad078 · Cited by 7
Gutowski, M., Klimkiewicz, J., Michałowski, A., Ordak, M., Możański, M., & Lubas, A. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12155049 · Cited by 8
“The use of antipsychotics for the prevention or treatment of delirium is not currently supported by evidence [22].”
BackgroundPatient Safety in Internal Medicine
Regina, M. L., Vecchié, A., Bonaventura, A., & Prisco, D. (2020) · Springer eBooks · doi:10.1007/978-3-030-59403-9_17 · Cited by 7
Nitchingham, A., Milne, A., Toson, B., Tuch, B. E., Agar, M. R., Close, J., & Caplan, G. A. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-050765 · Cited by 8
Perioperative medication management for older people
Johnson, S., & Haywood, C. J. (2022) · Journal of Pharmacy Practice and Research · doi:10.1002/jppr.1834 · Cited by 7
Nicholas, M., Wittmann, J., Norena, M., Ornowska, M., & Reynolds, S. (2023) · npj Digital Medicine · doi:10.1038/s41746-023-00950-4 · Cited by 7
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
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