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Melatonin Receptor Agonists for Delirium Prevention.
Cheri K Walker1,2, Mark A Gales1,3,4
11 Southwestern Oklahoma State University College of Pharmacy, Weatherford, OK, USA.
The Annals of Pharmacotherapy
|August 20, 2016
Summary
Melatonin receptor agonists show conflicting results for preventing delirium. Current evidence does not support their routine use in clinical practice for delirium prevention.
Area of Science:
- Clinical Medicine
- Pharmacology
- Critical Care Medicine
Background:
- Delirium is a common and serious complication in hospitalized patients.
- Effective preventive strategies for delirium are crucial to improve patient outcomes.
Purpose of the Study:
- To review prospective controlled trials on the efficacy of melatonin receptor agonists for delirium prevention.
Main Methods:
- A comprehensive literature search was performed using terms related to delirium and melatonin receptor agonists.
- Five randomized and one nonrandomized prospective controlled trials were included in the review.
- Trials investigating melatonin, l-tryptophan, and ramelteon for delirium prevention were evaluated.
Main Results:
- Clinical trial results for melatonin receptor agonists in delirium prevention are conflicting.
- Some trials showed significant reductions in delirium incidence (12%-30%), while others, including the largest trial, found no benefit.
- No benefit was observed with l-tryptophan, and a single small trial suggested decreased delirium incidence with ramelteon.
Conclusions:
- The routine use of melatonin receptor agonists for delirium prevention is not currently recommended.
- Further research is needed to clarify the role and safety of these agents in delirium prevention.
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