The effect of antipsychotics in the prevention and treatment of delirium in the elderly admitted to intensive care units: a systematic review

The present study reviews published studies on the effects of antipsychotic use in the treatment of delirium in the elderly in order to determine the effect of antipsychotic drugs on the prevention and treatment of delirium in the elderly admitted to the intensive care unit and the possible side effects of these drugs in this group of patients.

The present review article was conducted in the year1399-1400 by searching relevant keywords in English and Persian in national and international databases. 70 studies were included in the study in the first phase. After deleting duplicate and unrelated studies, 48 studies remained, and finally 19 studies were excluded due to problems such as the lack of eligible criteria for this study, and the remaining 29 studies in this article were reviewed.

Haloperidol, dexmedetomidine, risperidone, olanzapine, quetiapine, promazine, and clozapine are some of the common antipsychotic drugs used to treat delirium in the elderly. Although in some cases the use of these drugs can reduce the symptoms of delirium, but it can also cause side effects that include increased cerebrovascular complications, increased blood pressure and heart rate, dizziness, myocardial infarction, increased QT interval, tachycardia sinus, T-wave reversal, increased ST-segment elevation, ventricular atrial block, metabolic problems, sodium deficiency, hyperglycemia, pneumonia, and deep vein thrombosis.

According to the evidence obtained from the articles, the use of antipsychotics in the prevention and treatment of delirium in the elderly is not recommended, and in some cases it seems that the risk of using antipsychotics in the treatment of delirium in the elderly outweighs the benefits of using it. Therefore, due to the lack of sufficient evidence for the beneficial role of these drugs in the prevention and treatment of delirium in the elderly, it is recommended to pay more attention to preventive measures against delirium in this group of patients.