SynthesisActa psychiatrica Scandinavica2023
Delirium-associated medication in people at risk: A systematic update review, meta-analyses, and GRADE-profiles.
Synthesis in Acta psychiatrica Scandinavica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Medication Causes and Treatment of Delirium in Patients With and Without Dementia.Brain and behavior · 2025Pooled it
- Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis.Age and ageing · 2024Pooled it
- Delirium-associated medication in people at risk: A systematic update review, meta-analyses, and GRADE-profiles.Acta psychiatrica Scandinavica · 2023Pooled it
- Effects of narrative nursing on delirium and outcomes in mechanically ventilated ICU patients: a randomized trial.Trials · 2025Trial
- Effect of Low-Dose Esketamine on Postoperative Delirium in Elderly Patients Undergoing Total Hip or Knee Arthroplasty: A Randomized Controlled Trial.Drug design, development and therapy · 2024Trial
- Critical care delirium: prevention, identification and management: a narrative review.Anaesthesia · 2026Review
- From Sensory Deprivation to Psychosis: Environmental Mechanisms of Delirium in Dementia-An Eight-Year Retrospective Longitudinal Case Report and Narrative Review.Healthcare (Basel, Switzerland) · 2026Article
- Neuropsychiatric-pharmacologic synergy: interaction between psychiatric polypharmacy and cancer treatment-related neurotoxicity.Oxford medical case reports · 2026Article
- Article
- [Polypharmacy in patients with neuropsychiatric symptoms].Innere Medizin (Heidelberg, Germany) · 2026Article
- Comparative risk of delirium among opioid users for non-cancer pain: a retrospective cohort study.BMC medicine · 2026Article
- Hyperactive Delirium Temporally Associated With Hydroxyzine in a Child With Succinic Semialdehyde Dehydrogenase Deficiency Presenting With Psychotic Symptoms: A Case Report.Case reports in psychiatry · 2026Article
- A systematic review and meta-analysis on ketamine use and postoperative delirium in older patients undergoing spine or orthopedic surgery.Anesthesiology and perioperative science · 2026Review
- What's behind delirium: is there a specific role for medications?European geriatric medicine · 2025Review
- Comparative effects of fentanyl, morphine, and hydromorphone on postoperative delirium and outcomes after cardiac surgery: a propensity score-matched cohort study.Scientific reports · 2025Article
- Impact of CNS medication burden and drug interactions on delirium in patients with advanced cancer: a multicenter prospective observational study.Scientific reports · 2025Observational
- A simulation study comparing anticholinergic drug use with polypharmacy for risk of death, dementia, and delirium in UK Biobank.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- The Role of Quetiapine in Treating Delirium in Critical Care Settings: A Narrative Review.Journal of clinical medicine · 2025Review
- Author Response: The Range of Nonpharmacological Measures to Prevent Delirium on Intensive Care Units is Broader than Assumed.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Delirium in nursing home residents: is there a role of antidepressants? A cross sectional study.BMC geriatrics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrug-associated delirium is a common but potentially preventable neuropsychiatric syndrome associated with detrimental outcomes. Empirical evidence for delirium-associated medication is uncertain due to a lack of high-quality studies. We aimed to further investigate the body of evidence for drugs suspected to trigger delirium.
methodsA systematic update review and meta-analyses of prospective studies presenting drug associations with incident delirium in adult study populations was conducted. Two authors independently searched MEDLINE, PsycINFO, Embase, and Google Scholar dated from October 1, 2009 to June 23, 2020, after screening a previous review published in 2011. The most reliable results on drug-delirium associations were pooled in meta-analyses using the random-effects model. Quality of evidence was assessed using the GRADE-approach. This study is preregistered with OSF (DOI https://doi.org.10.17605/OSF.IO/4PUHY).
resultsThe 31 eligible studies, presenting results for 24 medication classes were identified. Meta-analyses and GRADE level of evidence ratings show no increased delirium risk for Haloperidol (OR: 0.96, 95% CI 0.72-1.28; high-quality evidence), Olanzapine (OR: 0.25, 95% CI 0.15-0.40), Ketamine (OR: 0.72, 95% CI 0.35-1.46) or corticosteroids (OR: 0.69, 95% CI 0.32-1.50; moderate quality evidence, respectively). Low-level evidence suggests a three-fold increased risk for anticholinergics (OR: 3.11, 95% CI 1.04-9.26). Opioids, benzodiazepines, H
conclusionWe investigated the retrievable body of evidence for delirium-associated medication. The results of this systematic review were then interpreted in conjunction with other evidence-based works and guidelines providing conclusions for clinical decision-making.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.