Antipsychotics used in hospital patients don't treat delirium, study finds

Powerful antipsychotic medications used in intensive care units, emergency rooms and hospital wards are ineffective at treating delirium, a study covered by NPR found.

"In some surveys, up to 70 percent of patients [in the ICU] get these antipsychotics," Eugene Wesley Ely, MD, professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn., told NPR. They're prescribed by "very good doctors at extremely good medical centers," he said. "Millions of people worldwide are getting these drugs to treat their delirium."

But these drugs can have harmful side effects, and there is no solid research showing they can effectively treat delirium, according to Dr. Ely.

The study, published in the New England Journal of Medicine, examined antipsychotic drug use at 16 U.S. medical centers.

The researchers split about 600 patients with delirium into three groups. The first group got the powerful antipsychotic haloperidol. The second got ziprasidone, which is a related medication from the atypical antipsychotic drug class, and the third group received a placebo.

"The three groups did exactly the same," Dr. Ely said. The study found no change in the duration of delirium or the number of coma-free days. The patients also stayed on the mechanical ventilator the same amount of time and did not leave the hospital any sooner.

"There's not a shred of evidence in this entire investigation that this aggressive approach to treating delirium with antipsychotics, which is commonplace and usual care, did anything for the patients," Dr. Ely said.

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