Section - Video Lectures

04. Do Antipsychotics Treat Delirium?

Published on May 1, 2021 Expired on April 1, 2025

Scott R. Beach, M.D.

Associate Professor of Psychiatry - Harvard Medical School - Massachusetts General Hospital

Key Points

Antipsychotics do not treat delirium.
Antipsychotics may be useful in cases of significant distress due to delirium or if patients are agitated.
There are no differences between antipsychotics in terms of delirium treatment.
The only treatment of delirium is to reverse the underlying cause and treat the medical illness.

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Slides and Transcript

Slide 1 of 12

The second important question that we want to ask ourselves is: Do medications particularly antipsychotic medications treat delirium?

Do Antipsychotics Treat Delirium? Slide 1 of 12

Slide 2 of 12

And in this context, I want to make a really important distinction between treatment and management. When I use the term treatment, I’m indicating a reversing of the delirium or shortening of the length of the delirium episode. Later, I’ll use the term management to refer to mitigating sequelae of delirium such as agitation and perceptual disturbances.

References:

Jacobi, J., Fraser, G. L., Coursin, D. B., Riker, R. R., Fontaine, D., Wittbrodt, E. T., Chalfin, D. B., Masica, M. F., Bjerke, H. S., Coplin, W. M., Crippen, D. W., Fuchs, B. D., Kelleher, R. M., Marik, P. E., Nasraway, S. A., Jr, Murray, M. J., Peruzzi, W. T., Lumb, P. D., & Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), American Society of Health-System Pharmacists (ASHP), American College of Chest Physicians (2002). Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Critical Care Medicine, 30(1), 119–141.
Barr, J., Fraser, G. L., Puntillo, K., Ely, E. W., Gélinas, C., Dasta, J. F., Davidson, J. E., Devlin, J. W., Kress, J. P., Joffe, A. M., Coursin, D. B., Herr, D. L., Tung, A., Robinson, B. R., Fontaine, D. K., Ramsay, M. A., Riker, R. R., Sessler, C. N., Pun, B., Skrobik, Y., … American College of Critical Care Medicine (2013). Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Critical Care Medicine, 41(1), 263–306.

Do Antipsychotics Treat Delirium? Slide 2 of 12

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05. Management of Delirium: Nonpharmacologic Strategies

Learning Objectives:

After completing this activity, the learner will be able to:

Identify and assess different symptoms and presentations of delirium
Summarize research on medications with evidence for the prevention and management of delirium
Discuss special considerations in delirium, such as catatonia and COVID-19 delirium

Original Release Date: 05/01/2021

Review and Re-release Date: 03/01/2024

Expiration Date: 04/01/2025

Expert: Scott Beach, M.D.

Medical Editor: Melissa Mariano, M.D

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationship(s) to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.