Abstract

AMIGO, Carolina; LOPEZ, Maynés; ORMAECHEA, Gabriela  and  TAMOSIUNAS, Gustavo. Efficacy and safety of antipsychotics in delirium. Rev. Urug. Med. Int. [online]. 2016, vol.1, n.3, pp.34-43. ISSN 2393-6797.

ABSTRACT   The main goal in delirium treatment is to identify and treat the triggering causes, being the pharmacological treatment mainly symptomatic. Delirium physiopathology is still unknow, and has been associated with an acetylcholine deficit and a dopamine excess in central nervous system. Those are the therapeutic targets that justify the use of antipsychotics.  Our objective was to review the evidence on efficacy and safety of antipsychotics in the treatment and prevention of delirium. A sistematic literature review was caried out in the main databases, including randomise clinilal trials, systematic reviews and meta-analyzes to evaluate the efficacy of antipsychotics in the prevention and treatment of delirium. Observational studies, case reports and international drug alerts were also included to evaluate safety.  We found a limited number of clinical trials evaluating efficacy between diferent antipsychotics and compared with placebo. Most of the analyzed studies show that in prophylaxis there are no clinically significant differences in the incidence of delirium among patients receving antipsychotics or placebo. For the symptomatic treatment of delirium, antipsychotics have shown benefits in reducing severity and duration of symptoms, with no significant differences between haloperidol and atypical antipsychotics. 

Keywords : Delirium; Antipsychotics; Off label use.

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