Delirium: treatment and prevention (part 2).

Delirium management begins with non-pharmacologic interventions and treatment of the underlying causes. There are no FDA-approved medications for delirium-related psychosis and agitation, although numerous agents have been studied. Small sample size, narrow inclusion criteria, lack of placebo controls and variable methodologies limit the generalizability of findings to date. Studies and expert guidelines support the use of antipsychotics for delirium-related psychosis and agitation, and demonstrate comparable efficacy and safety between first- and secondgeneration agents. Mounting evidence also suggests that antipsychotics and dexmedetomidine are effective in preventing delirium in surgical and mechanicallyventilated patients, respectively.