This article discusses a prospective observational study, conducted over 1 year at 33 general hospitals in Japan, into the risks and benefits of antipsychotics for older patients with delirium in general hospital settings.
Of 2834 patients who developed delirium, 2453 patients received antipsychotics such as risperidone, quetiapine, and parenteral haloperidol as a treatment for delirium. Just 22 patients developed serious adverse events, the most common being aspiration pneumonia (17 patients, 0.7%), followed by cardiovascular events (4 patients, 0.2%) and venous thromboembolism (1 patient, 0.0%). Injuries due to falls did not appear to be an outcome, and no one died from antipsychotic side effects.
The authors conclude that the risk of antipsychotics for older patients with delirium can be low in general hospital settings and with careful management (compared with well-documented adverse outcomes of antipsychotics for dementia in the nursing homes and outpatient settings). Risk monitoring may be important.
Hatta, K. Kishi, Y. [and] Wada, K. [et al] (2013). Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study. International Journal of Geriatric Psychiatry, June 25th 2013, [Epub ahead of print]. (Click here to view the PubMed abstract).