Management of Delirium in Palliative Care: a Review

Luigi Grassi, Augusto Caraceni, Alex J. Mitchell, Maria Giulia Nanni, Maria Alejandra Berardi, Rosangela Caruso, Michelle Riba

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalCurrent Psychiatry Reports
Volume17
Issue number3
DOIs
Publication statusPublished - 2015

Keywords

  • Delirium
  • Palliative care
  • Psychiatry
  • Psycho-oncology
  • Psychopharmacotherapy

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Medicine(all)

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