Management of Delirium in Palliative Care: a Review

Overview

Journal Curr Psychiatry Rep

Publisher Current Science

Specialty Psychiatry

Date 2015 Feb 10

PMID 25663153

Citations 19

Authors

Luigi Grassi

Augusto Caraceni

Alex J Mitchell

Maria Giulia Nanni

Maria Alejandra Berardi

Rosangela Caruso

Michelle Riba

Affiliations

Soon will be listed here.

Abstract

Delirium is a complex but common disorder in palliative care with a prevalence between 13 and 88 % but a particular frequency at the end of life (terminal delirium). By reviewing the most relevant studies (MEDLINE, EMBASE, PsycLit, PsycInfo, Cochrane Library), a correct assessment to make the diagnosis (e.g., DSM-5, delirium assessment tools), the identification of the possible etiological factors, and the application of multicomponent and integrated interventions were reported as the correct steps to effectively manage delirium in palliative care. In terms of medications, both conventional (e.g., haloperidol) and atypical antipsychotics (e.g., olanzapine, risperidone, quetiapine, aripiprazole) were shown to be equally effective in the treatment of delirium. No recommendation was possible in palliative care regarding the use of other drugs (e.g., α-2 receptors agonists, psychostimulants, cholinesterase inhibitors, melatonergic drugs). Non-pharmacological interventions (e.g., behavioral and educational) were also shown to be important in the management of delirium. More research is necessary to clarify how to more thoroughly manage delirium in palliative care.

Citing Articles

Preventing and treating delirium in clinical settings for older adults.

Faeder M, Hale E, Hedayati D, Israel A, Moschenross D, Peterson M Ther Adv Psychopharmacol. 2023; 13:20451253231198462.

PMID: 37701890 PMC: 10493062. DOI: 10.1177/20451253231198462.

Early Diagnosis of Delirium in Palliative Care Patients Decreases Mortality and Necessity of Palliative Sedation: Results of a Prospective Observational Study.

Beretta M, Uggeri S, Santucci C, Cattaneo M, Ermolli D, Gerosa C Cureus. 2022; 14(6):e25706.

PMID: 35812586 PMC: 9260701. DOI: 10.7759/cureus.25706.

Delirium in Palliative Care.

Bramati P, Bruera E Cancers (Basel). 2021; 13(23).

PMID: 34885002 PMC: 8656500. DOI: 10.3390/cancers13235893.

Risk Factors for Delirium in the Palliative Care Population: A Systematic Review and Meta-Analysis.

Guo D, Lin T, Deng C, Zheng Y, Gao L, Yue J Front Psychiatry. 2021; 12:772387.

PMID: 34744847 PMC: 8566675. DOI: 10.3389/fpsyt.2021.772387.

Narrative review of palliative care in trauma and emergency general surgery.

Ferre A, DeMario B, Ho V Ann Palliat Med. 2021; 11(2):936-946.

PMID: 34551577 PMC: 8901564. DOI: 10.21037/apm-20-2428.

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