Treating an established episode of delirium in palliative care: expert opinion and review of the current evidence base with recommendations for future development.

[1]  K. Nishimura,et al.  Treatment for delirium with risperidone: results of a prospective open trial with 10 patients. , 2003, General hospital psychiatry.

[2]  A. Abernethy,et al.  Changes in anticholinergic load from regular prescribed medications in palliative care as death approaches , 2009, Palliative medicine.

[3]  N. Slatkin,et al.  Treatment of opioid-induced delirium with acetylcholinesterase inhibitors: a case report. , 2004, Journal of pain and symptom management.

[4]  T. Nishikawa,et al.  Perospirone in the treatment of patients with delirium , 2007, Psychiatry and clinical neurosciences.

[5]  Maeve Leonard,et al.  The delirium experience: a review. , 2008, Journal of psychosomatic research.

[6]  Takeshi Inoue,et al.  A prospective, open-label, flexible-dose study of quetiapine in the treatment of delirium. , 2003, The Journal of clinical psychiatry.

[7]  L. Kappelle,et al.  A pilot study of rivastigmine in the treatment of delirium after stroke: A safe alternative , 2008, BMC Neurology.

[8]  E. Bruera,et al.  Neuroleptic dose in the management of delirium in patients with advanced cancer. , 2010, Journal of pain and symptom management.

[9]  T. Rummans,et al.  Delirium: An evidence-based medicine (EBM) monograph for psychosomatic medicine practice, comissioned by the Academy of Psychosomatic Medicine (APM) and the European Association of Consultation Liaison Psychiatry and Psychosomatics (EACLPP). , 2012, Journal of psychosomatic research.

[10]  J. Luxenberg,et al.  Antipsychotics for delirium. , 2007, The Cochrane database of systematic reviews.

[11]  N. Jackson,et al.  Neuropsychiatric complications of commonly used palliative care drugs , 2008, Postgraduate Medical Journal.

[12]  P. Trzepacz,et al.  Phenomenological and neuropsychological profile across motor variants of delirium in a palliative-care unit. , 2011, The Journal of neuropsychiatry and clinical neurosciences.

[13]  R. Bellomo,et al.  Dexmedetomidine vs. haloperidol in delirious, agitated, intubated patients: a randomised open-label trial , 2009, Critical care.

[14]  M. Maltoni,et al.  Impact of delirium on the short term prognosis of advanced cancer patients , 2000, Cancer.

[15]  M. Hofmann,et al.  Practice Guidelines for the Treatment of Patients With Delirium , 2007 .

[16]  T. Morita,et al.  Terminal delirium: families' experience , 2007, Palliative medicine.

[17]  Stein Kaasa,et al.  Patient demographics and centre description in European palliative care units , 2007, Palliative medicine.

[18]  R. Krushell,et al.  Donepezil in the prevention and treatment of post-surgical delirium. , 2005, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[19]  M. Rowbotham,et al.  Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients , 2006, Neurology.

[20]  L. Schneider,et al.  Risk of mortality among individual antipsychotics in patients with dementia. , 2012, The American journal of psychiatry.

[21]  P. Casey,et al.  The Use of Environmental Strategies and Psychotropic Medication in the Management of Delirium , 1996, British Journal of Psychiatry.

[22]  K. Lapane,et al.  Effect of a Pharmacist‐Led Multicomponent Intervention Focusing on the Medication Monitoring Phase to Prevent Potential Adverse Drug Events in Nursing Homes , 2011, Journal of the American Geriatrics Society.

[23]  A. Mudge,et al.  Improving quality of delirium care in a general medical service with established interdisciplinary care: a controlled trial , 2013, Internal medicine journal.

[24]  H. Tan,et al.  Correction: Differential Changes in QTc Duration during In-Hospital Haloperidol Use , 2012, PLoS ONE.

[25]  B. Candy,et al.  Drug therapy for delirium in terminally ill adult patients. , 2012, The Cochrane database of systematic reviews.

[26]  W. Breitbart,et al.  The delirium experience: delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. , 2002, Psychosomatics.

[27]  A. Caraceni,et al.  Palliating delirium in patients with cancer. , 2009, The Lancet. Oncology.

[28]  H. Shinno,et al.  Successful treatment with quetiapine for delirium in terminally ill cancer patients , 2007 .

[29]  M. Srisurapanont,et al.  P.5.e.002 An open-label study of quetiapine for delirium , 2006, European Neuropsychopharmacology.

[30]  J. Gladman,et al.  The diagnosis, prevalence and outcome of delirium in a cohort of older people with mental health problems on general hospital wards , 2014, International journal of geriatric psychiatry.

[31]  P. Gagnon.  Treatment of delirium in supportive and palliative care , 2008, Current opinion in supportive and palliative care.

[32]  J. Samet,et al.  Food and Drug Administration , 2007, BMJ : British Medical Journal.

[33]  S. Inouye,et al.  Associations between caregiver-perceived delirium in patients with cancer and generalized anxiety in their caregivers. , 2007, Journal of palliative medicine.

[34]  J. Gonzales,et al.  Antipsychotics in the Treatment of Delirium in Older Hospitalized Adults: A Systematic Review , 2011, Journal of the American Geriatrics Society.

[35]  G. Fraser,et al.  Continuous infusion of haloperidol controls agitation in critically ill patients , 1994, Critical care medicine.

[36]  Najma Siddiqi,et al.  Occurrence and outcome of delirium in medical in-patients: a systematic literature review. , 2006, Age and ageing.

[37]  T. Okuyama,et al.  Treatment of delirium with risperidone in cancer patients , 2012, Psychiatry and clinical neurosciences.

[38]  Kazuyoshi Sasaki,et al.  Usefulness of the leaflet-based intervention for family members of terminally ill cancer patients with delirium. , 2013, Journal of palliative medicine.

[39]  M. Abrahamowicz,et al.  Environmental Risk Factors for Delirium in Hospitalized Older People , 2001, Journal of the American Geriatrics Society.

[40]  F. Ferris,et al.  Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. , 2013, Journal of palliative medicine.

[41]  J. Bourgeois,et al.  Adjunctive valproic acid for delirium and/or agitation on a consultation-liaison service: a report of six cases. , 2005, The Journal of neuropsychiatry and clinical neurosciences.

[42]  D. Meagher,et al.  Improving delirium care through early intervention: from bench to bedside to boardroom , 2013, Journal of Neurology, Neurosurgery & Psychiatry.

[43]  Roger B. Davis,et al.  Pilot Randomized Trial of Donepezil Hydrochloride for Delirium After Hip Fracture , 2011, Journal of the American Geriatrics Society.

[44]  A. de Graeff,et al.  Palliative sedation therapy in the last weeks of life: a literature review and recommendations for standards. , 2007, Journal of palliative medicine.

[45]  C. Pae,et al.  Amisulpride versus quetiapine for the treatment of delirium: a randomized, open prospective study , 2005, International clinical psychopharmacology.

[46]  Martha D Buffum,et al.  Cognitive impairment and pain management: review of issues and challenges. , 2007, Journal of rehabilitation research and development.

[47]  M. Hanania,et al.  Melatonin for treatment and prevention of postoperative delirium. , 2002, Anesthesia and analgesia.

[48]  J. Devlin,et al.  Efficacy and safety of quetiapine in critically ill patients with delirium: A prospective, multicenter, randomized, double-blind, placebo-controlled pilot study* , 2010, Critical care medicine.

[49]  W. Breitbart,et al.  An open trial of aripiprazole for the treatment of delirium in hospitalized cancer patients , 2011, Palliative and Supportive Care.

[50]  P. Gagnon,et al.  Psychoactive medications and risk of delirium in hospitalized cancer patients. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[51]  W. Breitbart,et al.  Evidence-based treatment of delirium in patients with cancer. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[52]  D. Meagher,et al.  Reversibility of delirium in terminally ill patients and predictors of mortality , 2008, Palliative medicine.

[53]  B. Drew,et al.  High prevalence of corrected QT interval prolongation in acutely ill patients is associated with mortality: Results of the QT in Practice (QTIP) Study* , 2012, Critical care medicine.

[54]  W. Breitbart,et al.  Atypical antipsychotics in the management of delirium: A review of the empirical literature , 2005, Palliative and Supportive Care.

[55]  T. Morita,et al.  Underlying pathologies and their associations with clinical features in terminal delirium of cancer patients. , 2001, Journal of pain and symptom management.

[56]  C. Ritchie,et al.  A randomized, double‐blind, placebo‐controlled trial of donepezil hydrochloride (Aricept) for reducing the incidence of postoperative delirium after elective total hip replacement , 2007, International journal of geriatric psychiatry.

[57]  Lisa A. McLoughlin,et al.  What do we really know about the treatment of delirium with antipsychotics? Ten key issues for delirium pharmacotherapy. , 2013, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[58]  S. Gill,et al.  Antipsychotics in the treatment of delirium: a systematic review. , 2007, The Journal of clinical psychiatry.

[59]  William Breitbart,et al.  An open trial of olanzapine for the treatment of delirium in hospitalized cancer patients. , 2002, Psychosomatics.

[60]  B. Draper,et al.  Phase III randomised double-blind controlled trial of oral risperidone, haloperidol or placebo with rescue subcutaneous midazolam for delirium management in palliative care , 2015 .

[61]  P. Pandharipande,et al.  Statins and brain dysfunction: a hypothesis to reduce the burden of cognitive impairment in patients who are critically ill. , 2011, Chest.

[62]  D. Selby,et al.  Demographic profile and utilization statistics of a Canadian inpatient palliative care unit within a tertiary care setting , 2009, Current oncology.

[63]  Giuseppe Curigliano,et al.  Drug-induced prolongation of the QT interval. , 2004, The New England journal of medicine.

[64]  Letter to the editor: Multi-site research allows adequately powered palliative care trials; web-based data management makes it achievable today , 2008, Palliative medicine.

[65]  M. Suarez‐Almazor,et al.  Opioid rotation for toxicity reduction in terminal cancer patients. , 1995, Journal of pain and symptom management.

[66]  G. Bernard,et al.  Feasibility, efficacy, and safety of antipsychotics for intensive care unit delirium: The MIND randomized, placebo-controlled trial* , 2010, Critical care medicine.

[67]  D. Meagher.  Motor subtypes of delirium: Past, present and future , 2009, International review of psychiatry.

[68]  D. Meagher,et al.  Delirium: optimising management , 2001, BMJ : British Medical Journal.

[69]  M. Kuiper,et al.  Effect of rivastigmine as an adjunct to usual care with haloperidol on duration of delirium and mortality in critically ill patients: a multicentre, double-blind, placebo-controlled randomised trial , 2010, The Lancet.

[70]  J. Chae,et al.  An open pilot trial of olanzapine for delirium in the Korean population , 2001, Psychiatry and clinical neurosciences.

[71]  S. Yamawaki,et al.  Usage of haloperidol for delirium in cancer patients , 1996, Supportive Care in Cancer.

[72]  D. Farewell,et al.  A randomized controlled trial of quetiapine versus placebo in the treatment of delirium. , 2010, Journal of psychosomatic research.

[73]  E. Sampson,et al.  Drug treatment of delirium: past, present and future. , 2008, Journal of psychosomatic research.

[74]  Vineet Kumar,et al.  Comparative efficacy study of haloperidol, olanzapine and risperidone in delirium. , 2011, Journal of psychosomatic research.

[75]  M. Güden,et al.  Ondansetron hydrochloride for the treatment of delirium after coronary artery surgery. , 2001, The Journal of thoracic and cardiovascular surgery.

[76]  Elyssa L. Pohl,et al.  Aripiprazole in the Treatment of Delirium , 2005, International journal of psychiatry in medicine.

[77]  E. Vasilevskis,et al.  Future directions of delirium research and management. , 2012, Best practice & research. Clinical anaesthesiology.

[78]  S. Inouye,et al.  Delirium in older persons. , 2006, New England Journal of Medicine.

[79]  I. Higginson,et al.  What Is the Evidence That Palliative Care Teams Improve Outcomes for Cancer Patients and Their Families? , 2010, Cancer journal.

[80]  S. Gottfried,et al.  Olanzapine vs haloperidol: treating delirium in a critical care setting , 2004, Intensive Care Medicine.

[81]  J. Devlin,et al.  Impact of quetiapine on resolution of individual delirium symptoms in critically ill patients with delirium: a post-hoc analysis of a double-blind, randomized, placebo-controlled study , 2011, Critical care.

[82]  E. Bruera,et al.  The assessment and management of delirium in cancer patients. , 2009, The oncologist.

[83]  E. Bruera,et al.  Occurrence, causes, and outcome of delirium in patients with advanced cancer: a prospective study. , 2000, Archives of internal medicine.

[84]  M. Maltoni,et al.  Changing pattern of agitated impaired mental status in patients with advanced cancer: association with cognitive monitoring, hydration, and opioid rotation. , 1995, Journal of pain and symptom management.

[85]  R. Morrison,et al.  Relationship between pain and opioid analgesics on the development of delirium following hip fracture. , 2003, The journals of gerontology. Series A, Biological sciences and medical sciences.

[86]  Sharon K. Inouye,et al.  Delirium in elderly adults: diagnosis, prevention and treatment , 2009, Nature Reviews Neurology.

[87]  R. Hales,et al.  J Neuropsychiatry Clin Neurosci , 1992 .

[88]  Changsu Han,et al.  Antipsychotics and dopamine transporter gene polymorphisms in delirium patients , 2005, Psychiatry and clinical neurosciences.

[89]  Sung-Wan Kim,et al.  Risperidone versus olanzapine for the treatment of delirium , 2010, Human psychopharmacology.

[90]  D. Meagher,et al.  The active management of delirium: improving detection and treatment , 2008 .

[91]  R. Jaeschke,et al.  Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit , 2013, Critical care medicine.

[92]  B. Gagnon,et al.  Methylphenidate hydrochloride improves cognitive function in patients with advanced cancer and hypoactive delirium: a prospective clinical study. , 2005, Journal of psychiatry & neuroscience : JPN.

[93]  A. Ciampi,et al.  A retrospective, exploratory, secondary analysis of the association between antipsychotic use and mortality in elderly patients with delirium , 2009, International Psychogeriatrics.

[94]  P. Davidson,et al.  Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review , 2013, Palliative medicine.

[95]  B. V. van Munster,et al.  Differential Changes in QTc Duration during In-Hospital Haloperidol Use , 2011, PloS one.

[96]  M. Tsolaki,et al.  Ondasetron versus haloperidol for the treatment of postcardiotomy delirium: a prospective, randomized, double-blinded study , 2012, Journal of Cardiothoracic Surgery.

[97]  M. Little,et al.  Matching the Environment to Patients with Delirium: Lessons Learned from the Delirium Room, a Restraint‐Free Environment for Older Hospitalized Adults with Delirium , 2011, Journal of the American Geriatrics Society.

[98]  A. Wilcock,et al.  Prolongation of the QT interval in palliative care patients. , 2003, Journal of pain and symptom management.

[99]  B. Henry,et al.  Framework for continuous palliative sedation therapy in Canada. , 2012, Journal of palliative medicine.

[100]  F. Bellavance,et al.  Systematic detection and multidisciplinary care of delirium in older medical inpatients : a randomized trial , 2002 .

[101]  Philip S. Insel,et al.  Efficacy and adverse effects of atypical antipsychotics for dementia: meta-analysis of randomized, placebo-controlled trials. , 2006, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[102]  C Michael Stein,et al.  Atypical antipsychotic drugs and the risk of sudden cardiac death. , 2009, The New England journal of medicine.

[103]  A. Abernethy,et al.  Designing and conducting randomized controlled trials in palliative care: A summary of discussions from the 2010 clinical research forum of the Australian Palliative Care Clinical Studies Collaborative , 2012, Palliative medicine.

[104]  A. Abernethy,et al.  Analyzing phase III studies in hospice/palliative care. a solution that sits between intention-to-treat and per protocol analyses: the palliative-modified ITT analysis. , 2012, Journal of pain and symptom management.

[105]  E. Bruera,et al.  Opioid use in cancer pain. Is a more liberal approach enhancing toxicity? , 1999, Acta Anaesthesiologica Scandinavica.

[106]  L. Radbruch,et al.  Sedierung in der Palliativmedizin – Leitlinie1 für den Einsatz sedierender Maßnahmen in der Palliativversorgung , 2010 .

[107]  G. Murray,et al.  Decreased extrapyramidal symptoms with intravenous haloperidol. , 1987, The Journal of clinical psychiatry.

[108]  A. Leshner.  Science is revolutionizing our view of addiction--and what to do about it. , 1999, The American journal of psychiatry.

[109]  A. MacLullich,et al.  Who understands delirium? , 2011, Age and ageing.

[110]  W. Johnson,et al.  Risperidone in the treatment of delirium: results from a prospective open-label trial. , 2004, The Journal of clinical psychiatry.

[111]  N. Mitsakakis,et al.  Preoperative Use of Statins Is Associated with Reduced Early Delirium Rates after Cardiac Surgery , 2009, Anesthesiology.

[112]  W. Breitbart,et al.  A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients. , 1996, The American journal of psychiatry.

[113]  E. Bruera,et al.  Opioid switching: a systematic and critical review. , 2006, Cancer treatment reviews.

[114]  T. Morita,et al.  Terminal delirium: recommendations from bereaved families' experiences. , 2007, Journal of pain and symptom management.

[115]  W. Breitbart,et al.  Phenomenology of the subtypes of delirium: Phenomenological differences between hyperactive and hypoactive delirium , 2011, Palliative and Supportive Care.

[116]  P. Jacobsen,et al.  Efficacy of neuroleptics for hypoactive delirium. , 1994, The Journal of neuropsychiatry and clinical neurosciences.

[117]  P. Trzepacz,et al.  Designing clinical trials for the treatment of delirium. , 2008, Journal of psychosomatic research.

[118]  C. Schulz,et al.  Evidence for the use of Levomepromazine for symptom control in the palliative care setting: a systematic review , 2013, BMC Palliative Care.

[119]  J. Vella-Brincat,et al.  Haloperidol in palliative care , 2004, Palliative medicine.

[120]  P. Weiden,et al.  Clinical nonrecognition of neuroleptic-induced movement disorders: a cautionary study. , 1987, American Journal of Psychiatry.

[121]  I. Baeza,et al.  Risperidone in the treatment of patients with delirium. , 2004, The Journal of clinical psychiatry.

[122]  E. Bruera,et al.  Attrition rates, reasons, and predictive factors in supportive care and palliative oncology clinical trials , 2013, Cancer.

[123]  Yong-Ku Kim,et al.  A double-blind trial of risperidone and haloperidol for the treatment of delirium. , 2004, Psychosomatics.

[124]  G. Bader,et al.  Treatment of Delirium in Older Adults with Quetiapine , 2003, Journal of geriatric psychiatry and neurology.

[125]  J. Spiller,et al.  Hypoactive delirium: assessing the extent of the problem for inpatient specialist palliative care , 2006, Palliative medicine.

[126]  M. Maltoni,et al.  Palliative sedation in end-of-life care and survival: a systematic review. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[127]  E. Ely,et al.  Pharmacological and Nonpharmacological Management of Delirium in Critically Ill Patients , 2012, Neurotherapeutics.

[128]  A. Burns,et al.  Rivastigmine in the treatment of delirium in older people: a pilot study , 2010, International Psychogeriatrics.

[129]  Ahmed I. Othman,et al.  Early Treatment with Risperidone for Subsyndromal Delirium after On-pump Cardiac Surgery in the Elderly: A Randomized Trial , 2012, Anesthesiology.

[130]  M. Agar,et al.  Delirium in cancer patients: a focus on treatment-induced psychopathology , 2008, Current opinion in oncology.

[131]  David Clark,et al.  The changing model of palliative care , 2008 .

[132]  S. Berenson,et al.  Delirium in patients with cancer: nursing assessment and intervention. , 1990, Oncology nursing forum.

[133]  Soo-Jung Lee,et al.  A pilot trial of quetiapine for the treatment of patients with delirium , 2004, Human psychopharmacology.

[134]  F. Martin,et al.  The delirium experience: what is the effect on patients, relatives and staff and what can be done to modify this? , 2013, International journal of geriatric psychiatry.

[135]  L. Fillion,et al.  Delirium in Advanced Cancer: A Psychoeducational Intervention for Family Caregivers , 2002, Journal of palliative care.

[136]  T. Morita,et al.  Family-perceived distress from delirium-related symptoms of terminally ill cancer patients. , 2004, Psychosomatics.

[137]  E. Bruera,et al.  Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers , 2009, Cancer.

[138]  B. S. Andersson,et al.  Emergency pharmacotherapy of delirium in the critically ill cancer patient. , 1986, Psychosomatics.

[139]  P. Trzepacz,et al.  A longitudinal study of motor subtypes in delirium: relationship with other phenomenology, etiology, medication exposure and prognosis. , 2011, Journal of psychosomatic research.

[140]  A. Berney,et al.  Delirium: guidelines for general hospitals. , 2007, Journal of psychosomatic research.

[141]  M. Perreault,et al.  Systematic Review of Antipsychotics for the Treatment of Hospital-Associated Delirium in Medically or Surgically III Patients , 2006, The Annals of pharmacotherapy.