Use of Suvorexant and Antipsychotics in the Treatment of Delirium After Infectious Diseases: A Retrospective Study

J Clin Psychopharmacol. 2021 Sep-Oct;41(5):589-593. doi: 10.1097/JCP.0000000000001450.

Abstract

Background: Delirium is often treated on a subjective basis and per the discretion of the attending physician because of a lack of pharmacological evidence in the literature. To address this knowledge gap, we aimed to examine the efficacy of a hypnotic drug, suvorexant, as a therapeutic agent for the treatment of delirium.

Methods: Fifty-seven patients were targeted. Of the 57 patients, 39 were in the subolexant group, 17 in the antipsychotic group, and 1 was taking antidepressants. The Delirium Rating Scale-Revised 98 was used to evaluate the symptoms of delirium before and 3 and 7 days after drug administration. In addition, the medical history, occurrence of adverse effects, white blood cell count, and C-reactive protein level of participants were examined.

Results: Both drugs exhibited therapeutic effects on delirium, but suvorexant had a more pronounced effect. Furthermore, the suvorexant group exhibited decreased levels of C-reactive protein, suggesting an anti-inflammatory effect. Suvorexant seems to improve the symptoms of inflammation-related delirium without any serious adverse effects, suggesting that it can be explored as a safe treatment option for clinical use in future studies.

Conclusions: Our findings will be relevant for physicians interested in learning about new pharmacological treatment options and researchers interested in validating our results.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use*
  • Azepines / therapeutic use*
  • Communicable Diseases / complications*
  • Delirium / drug therapy*
  • Delirium / etiology
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Triazoles / therapeutic use*

Substances

  • Antipsychotic Agents
  • Azepines
  • Triazoles
  • suvorexant