Pharmacological Prevention and Treatment of Delirium: A Systematic Review of Published Clinical Psychiatry Guidelines

Abstract Purpose of Review Delirium due to an underlying causal condition or etiology is a common complication in hospitalized patients, especially among older individuals. Due to its complex nature and similarity in appearance with other psychiatric and neurological conditions, delirium is often unrecognised or wrongly diagnosed. Clinical guidelines should guide treatment decisions but there is a lack of clear, comprehensive, and easily implementable guidelines. The purpose of this review is to summarize the information provided by psychiatry guidelines on pharmacological causes, treatment options, and alternatives in adult delirium patients (> 18 years) with and without dementia, thereby facilitating patient management and care in psychiatric settings. Recent Findings The systematic review analyzed information from six international clinical guidelines aimed at treating patients with delirium. All guidelines focused on delirium with only one guideline offering some additional information on the treatment of delirium in dementia patients. Among all the medications listed in relation to, antipsychotics are the most frequently recommended. Only one guideline provides more detailed information on dosages, therapy duration and pharmacokinetic profiles in relation to individual medicines. Clinical guidelines are based on original studies that contain significant inconsistencies in medication efficacy, leading to a paucity of specific information in these guidelines and considerable discrepancies among them. Summary There is still a need for clear and consistent evidence on pharmacological causes, treatment options, and alternatives in adult delirium patients (>18 years) with and without dementia.