Editing Delirium (section)

===Medications===

The use of medications for delirium is generally restricted to managing its distressing or dangerous neuropsychiatric disturbances. Short-term use (one week or less) of low-dose [[haloperidol]] is among the more common pharmacological approaches to delirium.<ref name="Inouye2006" /><ref name="NICE" /> Evidence for effectiveness of [[atypical antipsychotic]]s (e.g. [[risperidone]], [[olanzapine]], ziprasidone, and [[quetiapine]]) is emerging, with the benefit for fewer side effects<ref name="Inouye2006" /><ref>{{cite book| vauthors = Tyrer PJ, Silk KR |title=Cambridge Textbook of Effective Treatments in Psychiatry |date=2008 |publisher=Cambridge University Press |isbn=9780511393020 |location=Leiden |oclc=437204638}}</ref> Use antipsychotic drugs with caution or not at all for people with conditions such as [[Parkinson's disease]] or [[dementia with Lewy bodies]].<ref name = NICE /> Evidence for the effectiveness of medications (including [[antipsychotic]]s and [[benzodiazepine]]s) in treating delirium is weak.<ref name="Soiza_2019">{{cite journal | vauthors = Soiza RL, Myint PK | title = The Scottish Intercollegiate Guidelines Network (SIGN) 157: Guidelines on Risk Reduction and Management of Delirium | journal = Medicina | volume = 55 | issue = 8 | pages = 491 | date = August 2019 | pmid = 31443314 | pmc = 6722546 | doi = 10.3390/medicina55080491 | doi-access = free }}</ref><ref name="Burry_2019" />

Benzodiazepines can cause or worsen delirium, and there is no reliable evidence of efficacy for treating non-anxiety-related delirium.<ref name="Challenges of Delirium Management i">{{cite journal | vauthors = Roberson SW, Patel MB, Dabrowski W, Ely EW, Pakulski C, Kotfis K | title = Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice | journal = Current Neuropharmacology | volume = 19 | issue = 9 | pages = 1519–1544 | date = 2021-09-14 | pmid = 33463474 | pmc = 8762177 | doi = 10.2174/1570159X19666210119153839 }}</ref> Similarly, people with [[dementia with Lewy bodies]] may have significant side effects with antipsychotics, and should either be treated with a none or small doses of benzodiazepines.<ref name="NICE" />

The antidepressant [[trazodone]] is occasionally used in the treatment of delirium, but it carries a risk of over-sedation, and its use has not been well studied.<ref name=Inouye2006/>

For adults with delirium that are in the ICU, medications are used commonly to improve the symptoms. [[Dexmedetomidine]] may shorten the length of the delirium in adults who are critically ill, and [[rivastigmine]] is not suggested.<ref name="Burry_2019" /> For adults with delirium who are near the end of their life (on palliative care) high quality evidence to support or refute the use of most medications to treat delirium is not available.<ref name="Finucane_2020">{{cite journal | vauthors = Finucane AM, Jones L, Leurent B, Sampson EL, Stone P, Tookman A, Candy B | title = Drug therapy for delirium in terminally ill adults | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | pages = CD004770 | date = January 2020 | pmid = 31960954 | pmc = 6984445 | doi = 10.1002/14651858.CD004770.pub3 }}</ref> Low quality evidence indicates that the [[antipsychotic medication]]s risperidone or haloperidol may make the delirium slightly worse in people who are terminally ill, when compared to a [[placebo]] treatment.<ref name="Finucane_2020" /> There is also moderate to low quality evidence to suggest that haloperidol and risperidone may be associated with a slight increase in side effects, specifically [[Extrapyramidal symptoms|extrapyramidal]] symptoms, if the person near the end of their life has delirium that is mild to moderate in severity.<ref name="Finucane_2020" />