Cyproheptadine for the Prevention of Postoperative Delirium: A Pilot Study

Postoperative delirium is a common neurobehavioral complication after major surgeries. There is no conclusive approach for prevention of delirium in these patients.

In this study, efficacy of cyproheptadine for prevention of postoperative delirium was evaluated.

Delirium status of surgical patients was evaluated postoperatively at the time of admission to the intensive care unit (ICU) using the Confusion Assessment Method (CAM-ICU) scale. Patients without delirium were assigned to the cyproheptadine or placebo group based on the simple randomization method. Patients received cyproheptadine or placebo tablet at a dose of 4 mg 3 times per day for 7 days. Patients were monitored daily for incidence of delirium.

Changes in the incidence rates of delirium over time during the study phase (P = 0.04) and between the groups showed statistically significant differences (P = 0.029). However, severity of delirium was not significantly different between the cyproheptadine and placebo groups during the study period.

It seems that cyproheptadine with its diverse effects can be a potential option for prevention of postoperative delirium. In this pilot study, cyproheptadine significantly decreased the incidence but not severity of postoperative delirium.