Pharmacologic Treatment for Hypoactive Delirium in Adult Patients: A Brief Report of the Literature

Elke Lodewijckx; Aziz Debain; Siddhartha Lieten; Bert Bravenboer; Tony Mets

doi:10.1016/j.jamda.2020.12.037

Pharmacologic Treatment for Hypoactive Delirium in Adult Patients: A Brief Report of the Literature

Elke Lodewijckx, Aziz Debain, Siddhartha Lieten, Bert Bravenboer, Tony Mets

Research output: Contribution to journal › Article

Abstract

OBJECTIVES: The purpose of this report was to identify medications that can be used to treat hypoactive delirium.

DESIGN: A systematic search of PubMed and Web of Science from inception through September 20, 2020.

SETTING AND PARTICIPANTS: Reports evaluating different pharmacologic treatments for hypoactive delirium in adults (age 18 years and older) and geriatric patients were included.

METHODS: Three independent investigators reviewed the abstracts, using the Rayyan QCRI review tool to decide which articles were eligible for inclusion. Hereafter, articles were read completely for final inclusion. Study quality was assessed using the guidelines from the National Institute for Health and Care Excellence for cohort studies and randomized control trials.

RESULTS: Of the 52 relevant articles, only 4 (8%) met the selection criteria. Two were cohort studies whereas the other 2 were randomized control trials. After further review, one of the reports was excluded because the same data were used as in one of the randomized control trials. In total, 4 different pharmacologic therapies were used in the selected studies: haloperidol, ziprasidone, aripiprazole, and methylphenidate. Aripiprazole showed a complete resolution of hypoactive delirium (P < .001), and methylphenidate showed a significant amelioration in cognitive function (P < .001). Ziprasidone and haloperidol did not show significant differences compared with placebo.

CONCLUSIONS AND IMPLICATIONS: A limited number of clinical studies on the treatment of hypoactive delirium are available. Aripiprazole and methylphenidate showed promising results in the treatment of hypoactive delirium.

Original language	English
Journal	Journal of the American Medical Directors Association
DOIs	https://doi.org/10.1016/j.jamda.2020.12.037
Publication status	E-pub ahead of print - 5 Feb 2021

Bibliographical note

Keywords

Geriatric
confusion
hypoactive delirium
treatment

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@article{e089d2fccf9645ab91ceb9feb9d498d2,

title = "Pharmacologic Treatment for Hypoactive Delirium in Adult Patients: A Brief Report of the Literature",

abstract = "OBJECTIVES: The purpose of this report was to identify medications that can be used to treat hypoactive delirium.DESIGN: A systematic search of PubMed and Web of Science from inception through September 20, 2020.SETTING AND PARTICIPANTS: Reports evaluating different pharmacologic treatments for hypoactive delirium in adults (age 18 years and older) and geriatric patients were included.METHODS: Three independent investigators reviewed the abstracts, using the Rayyan QCRI review tool to decide which articles were eligible for inclusion. Hereafter, articles were read completely for final inclusion. Study quality was assessed using the guidelines from the National Institute for Health and Care Excellence for cohort studies and randomized control trials.RESULTS: Of the 52 relevant articles, only 4 (8{\%}) met the selection criteria. Two were cohort studies whereas the other 2 were randomized control trials. After further review, one of the reports was excluded because the same data were used as in one of the randomized control trials. In total, 4 different pharmacologic therapies were used in the selected studies: haloperidol, ziprasidone, aripiprazole, and methylphenidate. Aripiprazole showed a complete resolution of hypoactive delirium (P < .001), and methylphenidate showed a significant amelioration in cognitive function (P < .001). Ziprasidone and haloperidol did not show significant differences compared with placebo.CONCLUSIONS AND IMPLICATIONS: A limited number of clinical studies on the treatment of hypoactive delirium are available. Aripiprazole and methylphenidate showed promising results in the treatment of hypoactive delirium.",

keywords = "Geriatric, confusion, hypoactive delirium, treatment",

author = "Elke Lodewijckx and Aziz Debain and Siddhartha Lieten and Bert Bravenboer and Tony Mets",

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AU - Debain, Aziz

AU - Lieten, Siddhartha

AU - Bravenboer, Bert

AU - Mets, Tony

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N2 - OBJECTIVES: The purpose of this report was to identify medications that can be used to treat hypoactive delirium.DESIGN: A systematic search of PubMed and Web of Science from inception through September 20, 2020.SETTING AND PARTICIPANTS: Reports evaluating different pharmacologic treatments for hypoactive delirium in adults (age 18 years and older) and geriatric patients were included.METHODS: Three independent investigators reviewed the abstracts, using the Rayyan QCRI review tool to decide which articles were eligible for inclusion. Hereafter, articles were read completely for final inclusion. Study quality was assessed using the guidelines from the National Institute for Health and Care Excellence for cohort studies and randomized control trials.RESULTS: Of the 52 relevant articles, only 4 (8%) met the selection criteria. Two were cohort studies whereas the other 2 were randomized control trials. After further review, one of the reports was excluded because the same data were used as in one of the randomized control trials. In total, 4 different pharmacologic therapies were used in the selected studies: haloperidol, ziprasidone, aripiprazole, and methylphenidate. Aripiprazole showed a complete resolution of hypoactive delirium (P < .001), and methylphenidate showed a significant amelioration in cognitive function (P < .001). Ziprasidone and haloperidol did not show significant differences compared with placebo.CONCLUSIONS AND IMPLICATIONS: A limited number of clinical studies on the treatment of hypoactive delirium are available. Aripiprazole and methylphenidate showed promising results in the treatment of hypoactive delirium.

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