Use of Antipsychotic Medications in Non-Substance-Related Delirium—the Gap Between Research Findings and Clinical Practices

Document Type



Brain and Mind Institute


Purpose of the review Gaps exist between the research knowledge base and clinical practices pertaining to the use of antipsychotics in delirium. We reviewed 19 major randomized studies on the use of antipsychotics in non-substance-related delirium to understand factors contributing to this gap. Recent findings Based on limited literature, antipsychotics are not effective in treating delirium in patients who are mechanically ventilated intensive care unit patients and those in palliative care, but they may be effective in preventing delirium in high-risk patients after elective surgery. The literature on the use of antipsychotics for delirium in general hospital patients is less clear. Summary Delirium is a complex and heterogeneous syndrome and is influenced by several individual and clinical factors, which make researching its pharmacological treatment very difficult. Furthermore, heterogeneity of the studies is a barrier to reliable meta-analyses. Until methodologically sound literature pertinent to specific patient populations and clinical scenarios accumulates, we should use both the research literature and clinical expertise to formulate practice guidelines.


This work was published before the author joined Aga Khan University.


Curr Treat Options Psych