Atypical antipsychotics not safer than haloperidol for older adults with postoperative delirium: Study

A examine of greater than 17,000 older adults prescribed an antipsychotic remedy after main surgical procedure discovered that atypical antipsychotics are usually not much less dangerous than haloperidol. The findings are revealed in Annals of Inner Drugs.

Postoperative delirium is the commonest complication after main surgical procedure in older adults. It’s related to longer hospital stays, institutional discharge, decline in perform, mortality, and elevated well being care prices. Nonpharmacologic interventions are really useful for preliminary remedy of delirium, however antipsychotics are nonetheless usually used to handle behavioral signs.

Earlier analysis discovered that the usage of haloperidol has declined, and atypical antipsychotic use has elevated over time. Such developments mirror clinicians’ notion that atypical antipsychotics are much less dangerous than haloperidol.

Researchers from Hebrew SeniorLife, Brigham and Ladies’s Hospital, and Harvard Medical College studied 17,115 sufferers aged 65 years and older with out psychiatric problems who had been prescribed an oral antipsychotic drug after main surgical procedure to match the danger for in-hospital hostile occasions. The authors discovered that amongst 4 antipsychotics, there was no statistically vital distinction within the threat for in-hospital loss of life amongst sufferers handled with haloperidol, olanzapine, quetiapine, and risperidone.

The chance for nonfatal scientific occasions ranged from 2.0% to 2.6% for a cardiac arrhythmia occasion, 4.2% to 4.6% for pneumonia, and 0.6% to 1.2% for stroke or transient ischemic assault, with no statistically vital variations by remedy group. The authors advocate lowering antipsychotic use altogether as there isn’t a safer antipsychotic drug possibility and focusing concerted scientific and well being coverage efforts and funding in nonpharmacologic interventions for delirium prevention and administration.

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Annals of Inner Drugs