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

A research of greater than 17,000 older adults prescribed an antipsychotic treatment 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 beneficial for preliminary therapy of delirium, however antipsychotics are nonetheless usually used to handle behavioral signs.

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

Researchers from Hebrew SeniorLife, Brigham and Girls’s Hospital, and Harvard Medical Faculty studied 17,115 sufferers aged 65 years and older with out psychiatric issues who have 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 danger for in-hospital loss of life amongst sufferers handled with haloperidol, olanzapine, quetiapine, and risperidone.

The danger for nonfatal medical 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 therapy group. The authors advocate decreasing antipsychotic use altogether as there isn’t a safer antipsychotic drug possibility and focusing concerted medical and well being coverage efforts and funding in nonpharmacologic interventions for delirium prevention and administration.

Offered by
Annals of Inner Drugs