The benefit of antipsychotics for the management of delirium in terminally ill patients has been called into question by a randomized trial in which 247 inpatients of a hospice or palliative care service with mild to moderately severe delirium were assigned oral risperidone, haloperidol or placebo every 12 hours for 72 hours.
Patients who received antipsychotics had more severe delirium, worse delirium-associated distress scores, more use of midazolam, more extrapyramidal effects and worse short-term survival.
The authors conclude that “antipsychotic drugs should not be added to manage specific symptoms of delirium that are known to be associated with distress in patients receiving palliative care who have mild to moderately severe delirium. Rather, management relies on ensuring systematic screening (given that two-thirds of people with delirium are not diagnosed on referral to palliative care), reversing the precipitants of delirium, and providing supportive interventions”.
To read the full study, click on the following link: http://bit.ly/2p0Dsjx
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