Pharmacotherapy for elderly patients with delirium in a general ward setting: A retrospective study

Ohsako, Noriaki; Hashimoto, Tasuku; Shiko, Yuki; Kawasaki, Yohei; Nakagawa, Mei; Okuma, Takahiro; Kurata, T; Suzuki, Hitoshi; Ishige, Minoru; Kikuchi, Shuichi

doi:10.1016/j.ajp.2022.103024

“…Other non-antipsychotic medications show promise in managing delirium-associated agitation. These include trazodone, ramelteon, melatonin, and suvorexant 37. These agents are believed to work by regulating the patient's sleep-wake cycle to allow for more restful and restorative nighttime sleep.…”

Section: Delirium Managementmentioning

confidence: 99%

“…Th ese include trazodone, ramelteon, melatonin, and suvorexant. 37 Th ese agents are believed to work by regulating the patient's sleep-wake cycle to allow for more restful and restorative nighttime sleep. Th erefore, these medications should be used at bedtime instead of during the day.…”

Section: Nonpharmacologic Interventionsmentioning

confidence: 99%

Delirium prevention and management in hospitalized older adults

Blodgett

¹

2023

The Nurse Practitioner

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“…The low anticholinergic effects also make Trazodone safe in elderly people with cognitive impairment and delirium [121][122][123][124].…”

Section: When Depression Gets Old and Sick: Unmet Needs Of Depression...mentioning

confidence: 99%

Treating Depression in Clinical Practice: New Insights on the Multidisciplinary Use of Tradozone

Albert¹,

Tomasetti²,

Marra³

et al. 2023

Preprint

1

0

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Depression is estimated to be a leading contributor to the global mental health-related burden. The determinants of this huge prevalence lie in the fact that depressive symptoms may be comorbid in a wide variety of disorders, thus complicating and exacerbating their clinical pictures. This makes the treatment of depressive symptoms even more difficult since many pharmacological and pharmacokinetic interactions should be considered by physicians approaching the therapy. Hence, depression still represents a challenge for both psychiatrists and the other clinicians, in terms of its high rates of relapse and resistance despite well-established protocols. It is also complicated by the well-known latency in its complete response to current antidepressant treatments. In this context, the search for new strategies in antidepressant treatment is mandatory; even including revising the use of “old” pharmacotherapies by considering their specific features may help to perfecting the treatment of depression, both in its standalone psychiatric manifestation and in the framework of other clinical conditions. The results of a consensus of experts regarding the possible use of trazodone as a valuable strategy for addressing the “real world” unmet needs of depression treatment is herein reported. This is based on the unique characteristics of this drug possibly delivering a rapid antidepressant action as compared to other selective serotonin reuptake inhibitors (SSRIs) as well as on its pharmacodynamic malleability and pharmacokinetic tolerability when used in the milieu of other drugs in treating comorbid depressive symptoms.

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“…,Trazodone has demonstrated efficacy in reducing depressive symptoms, anxiety, insomnia, agitation and apathy in both dementia and delirium (117). The low anticholinergic effects also make trazodone safe in elderly people with cognitive impairment and delirium (118)(119)(120)(121). Moreover, recent studies have demonstrated that patients with dementia taking trazodone may have delayed decline in cognition (122).…”

Section: When Depression Gets Old…and Sick: the Unmet Needs Of Depres...mentioning

confidence: 99%

Treating depression in clinical practice: new insights on the multidisciplinary use of trazodone

Albert,

Tomasetti,

Marra

et al. 2023

Front. Psychiatry

5

0

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Depression is estimated to be a leading contributor to the global mental health-related burden. The determinants of this huge prevalence lie in the fact that depressive symptoms may be comorbid in a wide variety of disorders, thus complicating and exacerbating their clinical framework. This makes the treatment of depressive symptoms difficult, since many pharmacological interactions should be considered by physicians planning therapy. Hence, depression still represents a challenge for both psychiatrists and other clinicians, in terms of its high rates of relapse and resistance despite well-established protocols. It is also complicated by the well-known latency in its complete response to current antidepressant treatments. In this context, the search for new strategies regarding antidepressant treatment is mandatory. Revising the use of “old” pharmacotherapies by considering their specific features may help to perfecting the treatment of depression, both in its standalone psychiatric manifestation and in the framework of other clinical conditions. Using a nominal group technique approach, the results of a consensus of expert physicians regarding the possible use of trazodone as a valuable strategy for addressing the “real world” unmet needs of depression treatment in different fields (psychiatry, primary care, neurology and geriatrics) is herein provided. This idea is based on the unique characteristics of this drug which delivers a more rapid antidepressant action as compared to other selective serotonin reuptake inhibitors. It also has pharmacodynamic malleability (i.e., the possibility of exerting different effects on depressive symptoms at different dosages) and pharmacokinetic tolerability (i.e., the possibility of being used as an add-on to other antidepressants with scarce interaction and achieving complimentary effects) when used in the milieu of other drugs in treating comorbid depressive symptoms. Moreover, the large number of formulations available permits finite dosage adjustments, and the use of trazodone for specific pathologies, such as dysphagia. Therefore, although additional studies exploring the real-world conditions of antidepressant treatment are warranted, experts agree on the idea that depressive disorder, in both its standalone and its comorbid manifestations, may surely take advantage of the particular characteristics of trazodone, thus attempting to reach the greatest effectiveness in different contexts.

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Pharmacotherapy for elderly patients with delirium in a general ward setting: A retrospective study

Cited by 3 publications

References 23 publications

Delirium prevention and management in hospitalized older adults

Delirium prevention and management in hospitalized older adults

Treating Depression in Clinical Practice: New Insights on the Multidisciplinary Use of Tradozone

Treating depression in clinical practice: new insights on the multidisciplinary use of trazodone

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