Antipsychotics May Worsen Delirium in Palliative Patients

Delirium is one of the most common clinical conditions in palliative care and manifests as cognitive changes, perceptual disturbances, and behavioral agitation. When the underlying cause cannot be reversed, the standard first-line therapy for delirium typically includes antipsychotics.  Although generally accepted as effective and appropriate by the medical community, antipsychotics have not been evaluated in placebo-controlled trials. A recent double-blind, parallel-arm, randomized, controlled trial of 247 palliative patients with delirium compared the efficacy of risperidone or haloperidol to placebo and found that antipsychotic drugs were not useful in reducing distressing symptoms.


Link to MedPageToday: Antipsychotics Found Not Helpful in Palliative Delirium article (12/2016) and JAMA Internal Medicine: Efficacy of Oral Risperidone, Haloperidol, or Placebo for Symptoms of Delirium Among Patients in Palliative Care article (1/2017)