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.
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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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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
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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
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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