Melatonin decreases delirium in elderly patients: A randomized, placebo-controlled trial
| Autor: | Sarah Woolmore-Goodwin, Tareef Al-Aama, Iris Gutmanis, Christopher Brymer, Monidipa Dasgupta, Jacquelin Esbaugh |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Placebo-controlled study Placebo Lower risk law.invention Melatonin Double-Blind Method Randomized controlled trial law Internal medicine Acute care mental disorders Humans Medicine Intensive care medicine Aged Aged 80 and over Ontario Intention-to-treat analysis business.industry Central Nervous System Depressants Delirium Psychiatry and Mental health Acute Disease Female Geriatrics and Gerontology medicine.symptom business medicine.drug |
| Zdroj: | International Journal of Geriatric Psychiatry. 26:687-694 |
| ISSN: | 0885-6230 |
| DOI: | 10.1002/gps.2582 |
| Popis: | Background Disturbance in the metabolism of tryptophan and tryptophan-derived compounds (e.g., melatonin) may have a role in the pathogenesis of delirium. Objective To evaluate the efficacy of low dose exogenous melatonin in decreasing delirium. Design A randomized, double-blinded, placebo-controlled study. Setting An Internal Medicine service in a tertiary care centre in London, Ontario, Canada. Participants 145 individuals aged 65 years or over admitted through the emergency department to a medical unit in a tertiary care hospital. Intervention Patients were randomized to receive either 0.5 mg of melatonin or placebo every night for 14 days or until discharge. Measurements The primary outcome was the occurrence of delirium as determined by Confusion Assessment Method (CAM) criteria. Results Of a total of 145 individuals (mean age (standard deviation): 84.5 (6.1) years) 72 were randomly assigned to the melatonin group and 73 to the placebo group. Melatonin was associated with a lower risk of delirium (12.0% vs. 31.0%, p = 0.014), with an odds ratio (OR), adjusted for dementia and co-morbidities of 0.19 (95% confidence intervals (CI): 0.06–0.62). Results were not different when patients with prevalent delirium were excluded. Limitation An intention to treat analysis was not possible due to loss to follow-up. Conclusion Exogenous low dose melatonin administered nightly to elderly patients admitted to acute care may represent a potential protective agent against delirium. Copyright © 2010 John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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