A literature review of the atypical antipsychotics in the management of delirium : implications for mental health liaison practice

Interventions for delirium have traditionally been separated into two distinct areas, non-pharmacological and pharmacological treatments. The aim of this study was to review recent research literature on the effectiveness of the atypical antipsychotics in the management of delirium. An electronic database search through Medline, CINAHL, PsychINFO and Google scholar was conducted using the key words; behaviour management, challenging behaviours, delirium, risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone, atypical, and antipsychotics. Results from systematic reviews and meta-analyses of atypicals used in delirium management were also included. A total of 10 clinical trial papers and nine review papers were found that meet inclusion criteria for the study. There is enough evidence within the literature to support the use of the atypicals over the typicals, but discerning between the atypical antipsychotics is limited. Until prospective randomised control trials are completed with all the atypicals in the one study using standardised measures, clinicians will need to rely on expert level consensus evidence to inform their practice.