Preventive Effects of Ramelteon, Suvorexant, and Lemborexant on Delirium in Hospitalized Patients With Physical Disease: A Retrospective Cohort Study.

Autor:	Henmi R; From the Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan., Nakamura T; From the Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan., Mashimoto M, Takase F, Ozone M; From the Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
Jazyk:	angličtina
Zdroj:	Journal of clinical psychopharmacology [J Clin Psychopharmacol] 2024 Jul-Aug 01; Vol. 44 (4), pp. 369-377. Date of Electronic Publication: 2024 Jun 03.
DOI:	10.1097/JCP.0000000000001876
Abstrakt:	Background: New sleep-inducing drugs (eg, ramelteon, suvorexant, and lemborexant) have been shown to prevent delirium in high-risk groups. However, no single study has simultaneously evaluated the delirium-preventing effects of all novel sleep-inducing drugs in hospitalized patients. Therefore, this study aimed to clarify the relationship between sleep-inducing drugs and delirium prevention in patients hospitalized in general medical-surgical settings for nonpsychiatric conditions who underwent liaison interventions for insomnia. Methods: This retrospective cohort study included patients treated in general medical-surgical settings for nonpsychiatric conditions with consultation-liaison psychiatry consult for insomnia. Delirium was diagnosed by fully certified psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders 5 th edition. The following items were retrospectively examined from medical records as factors related to delirium development: type of sleep-inducing drugs, age, sex, and delirium risk factors. The risk factors of delirium development were calculated using adjusted odds ratios (aORs) via multivariate logistic regression analysis. Results: Among the 710 patients analyzed, 257 (36.2%) developed delirium. Suvorexant (aOR, 0.61; 95% confidence interval [CI], 0.40-0.94; P = 0.02) and lemborexant (aOR, 0.23; 95% CI, 0.14-0.39; P < 0.0001) significantly reduced the risk of developing delirium. Benzodiazepines (aOR, 1.90; 95% CI, 1.15-3.13; P = 0.01) significantly increased this risk. Ramelteon (aOR, 1.30; 95% CI, 0.84-2.01; P = 0.24) and Z-drugs (aOR, 1.27; 95% CI, 0.81-1.98; P = 0.30) were not significantly associated with delirium development. Conclusions: The use of suvorexant and lemborexant may prevent delirium in patients with a wide range of medical conditions. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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