Journal of Psychiatry

Abstract

Effectiveness of Antipsychotics on Delirium in Elderly Patients

Miji Lee, Taeseung Kim, Sohyun Ahn and Jeong Lan Kim

Study background: Delirium is common in older adults, but the pharmacological treatment of delirium in the elderly has not been established. This study aimed to compare the efficacy of three atypical antipsychotics (amisulpride, quetiapine, and risperidone) for the treatment of delirium in patients aged >65 years. Methods: Psychiatrists examined subjects aged >65 years referred to the consultation–liaison psychiatry service for at baseline, day 3, and day 7. Totally, 129 subjects were enrolled and assigned to receive either amisulpride (n=44), quetiapine (n=44), risperidone (n=21), or not to receive any antipsychotic medications (n=20). We examined the efficacy of each medication using the Korean version of the Delirium Rating Scale-Revised-98, which investigates the severity of delirium episodes. We then evaluated the cognitive function of subjects using the Mini-Mental Status Examination. Results: At baseline, no significant differences were found among the four groups with regard to mean Korean version of the Delirium Rating Scale-Revised-98 or Mini-Mental Status Examination scores. In all groups, including the non-antipsychotic group, the Korean version of the Delirium Rating Scale-Revised-98 score decreased and Mini-Mental Status Examination score increased a week after the delirium diagnosis. There were no significant differences in improved Korean version of the Delirium Rating Scale-Revised-98 or Mini-Mental Status Examination scores among these four groups. Conclusion: Compared to subjects taking atypical antipsychotics, subjects not taking any antipsychotic medications equally improved their delirium symptoms and cognition. For hospitalized older adults with acute delirium, the data suggests that atypical antipsychotic treatment is ineffective for improving delirium outcomes.