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Current Psychiatry Reports
Published in: Current Psychiatry Reports 3/2015

01-03-2015 | Complex Medical-Psychiatric Issues (MB Riba, Section Editor)

Management of Delirium in Palliative Care: a Review

Authors: Luigi Grassi, Augusto Caraceni, Alex J. Mitchell, Maria Giulia Nanni, Maria Alejandra Berardi, Rosangela Caruso, Michelle Riba

Published in: Current Psychiatry Reports | Issue 3/2015

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Abstract

Delirium is a complex but common disorder in palliative care with a prevalence between 13 and 88 % but a particular frequency at the end of life (terminal delirium). By reviewing the most relevant studies (MEDLINE, EMBASE, PsycLit, PsycInfo, Cochrane Library), a correct assessment to make the diagnosis (e.g., DSM-5, delirium assessment tools), the identification of the possible etiological factors, and the application of multicomponent and integrated interventions were reported as the correct steps to effectively manage delirium in palliative care. In terms of medications, both conventional (e.g., haloperidol) and atypical antipsychotics (e.g., olanzapine, risperidone, quetiapine, aripiprazole) were shown to be equally effective in the treatment of delirium. No recommendation was possible in palliative care regarding the use of other drugs (e.g., α-2 receptors agonists, psychostimulants, cholinesterase inhibitors, melatonergic drugs). Non-pharmacological interventions (e.g., behavioral and educational) were also shown to be important in the management of delirium. More research is necessary to clarify how to more thoroughly manage delirium in palliative care.
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Metadata
Title
Management of Delirium in Palliative Care: a Review
Authors
Luigi Grassi
Augusto Caraceni
Alex J. Mitchell
Maria Giulia Nanni
Maria Alejandra Berardi
Rosangela Caruso
Michelle Riba
Publication date
01-03-2015
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 3/2015
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-015-0550-8

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