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cl:1-delirium [on February 1, 2024]
psychdb [Pharmacological] 		cl:1-delirium [on February 1, 2024]
psychdb [Pharmacological]
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     * The adverse effects of antipsychotic medications include sedation, hypotension,​ falls, [[geri:​parkinsons|parkinsonism]],​ [[meds:​qtc|QT interval prolongation]] and aspiration pneumonia.[([[https://​www.cmaj.ca/​content/​195/​31/​E1038|Reppas-Rindlisbacher,​ C., Wiesenfeld, L., & Stall, N. M. (2023). Antipsychotic medications for older adults with delirium admitted to hospital. CMAJ, 195(31), E1038-E1039.]])]     * The adverse effects of antipsychotic medications include sedation, hypotension,​ falls, [[geri:​parkinsons|parkinsonism]],​ [[meds:​qtc|QT interval prolongation]] and aspiration pneumonia.[([[https://​www.cmaj.ca/​content/​195/​31/​E1038|Reppas-Rindlisbacher,​ C., Wiesenfeld, L., & Stall, N. M. (2023). Antipsychotic medications for older adults with delirium admitted to hospital. CMAJ, 195(31), E1038-E1039.]])]
     * If there are [[meds:​qtc|QTc prolongation]] concerns, then lower-risk antipsychotics such as aripiprazole can also be used.[([[https://​pubmed.ncbi.nlm.nih.gov/​25514894/​|Kirino,​ E. (2015). Use of aripiprazole for delirium in the elderly: a short review. Psychogeriatrics,​ 15(1), 75-84.]])]     * If there are [[meds:​qtc|QTc prolongation]] concerns, then lower-risk antipsychotics such as aripiprazole can also be used.[([[https://​pubmed.ncbi.nlm.nih.gov/​25514894/​|Kirino,​ E. (2015). Use of aripiprazole for delirium in the elderly: a short review. Psychogeriatrics,​ 15(1), 75-84.]])]
 +  * Antipsychotics if prescribed, should be at the lowest effective dose for the shortest possible duration and be reevaluated at or shortly after discharge.[([[https://​www.cmaj.ca/​content/​195/​31/​E1038|Reppas-Rindlisbacher,​ C., Wiesenfeld, L., & Stall, N. M. (2023). Antipsychotic medications for older adults with delirium admitted to hospital. CMAJ, 195(31), E1038-E1039.]])]
   * There is some emerging evidence that [[meds:​melatonin-agonist:​melatonin|melatonin]] and melatonin agonists may be effective in the prevention and management of delirium.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​20845391|Al‐Aama,​ T., Brymer, C., Gutmanis, I., Woolmore‐Goodwin,​ S. M., Esbaugh, J., & Dasgupta, M. (2011). Melatonin decreases delirium in elderly patients: a randomized, placebo‐controlled trial. International journal of geriatric psychiatry, 26(7), 687-694.]])][([[https://​www.ncbi.nlm.nih.gov/​pubmed/​24554232|Hatta,​ K., Kishi, Y., Wada, K., Takeuchi, T., Odawara, T., Usui, C., & Nakamura, H. (2014). Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA psychiatry, 71(4), 397-403.]])]   * There is some emerging evidence that [[meds:​melatonin-agonist:​melatonin|melatonin]] and melatonin agonists may be effective in the prevention and management of delirium.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​20845391|Al‐Aama,​ T., Brymer, C., Gutmanis, I., Woolmore‐Goodwin,​ S. M., Esbaugh, J., & Dasgupta, M. (2011). Melatonin decreases delirium in elderly patients: a randomized, placebo‐controlled trial. International journal of geriatric psychiatry, 26(7), 687-694.]])][([[https://​www.ncbi.nlm.nih.gov/​pubmed/​24554232|Hatta,​ K., Kishi, Y., Wada, K., Takeuchi, T., Odawara, T., Usui, C., & Nakamura, H. (2014). Preventive effects of ramelteon on delirium: a randomized placebo-controlled trial. JAMA psychiatry, 71(4), 397-403.]])]