title: The pharmacologic management of delirium in children and adolescents.
abstract: Delirium is a serious and common problem in severely medically ill patients of all ages. It has been less addressed in children and adolescents. Treatment of delirium is predicated on addressing its underlying cause. The management of its symptoms depends on the off-label use of antipsychotics, while avoiding agents that precipitate or worsen delirium. Olanzapine, quetiapine, and risperidone are presently considered first-line drugs, usually replacing haloperidol. Other agents have shown promise, including melatonin to address the sleep disturbance characteristic of delirium, and dexmedetomidine, an α2-agonist, that may facilitate lower doses of benzodiazepines and opioids that may worsen delirium.
authors.affiliation: Departments of Psychiatry and Pediatrics, Keck School of Medicine, University of Southern California, Children's Hospital Los Angeles, 4650 Sunset Boulevard MS# 167, Los Angeles, CA, 90027, USA, sbturkel@usc.edu.
authors.forename: Susan Beckwitt
authors.initials: SB
authors.lastname: Turkel
authors.forename: Alan
authors.initials: A
authors.lastname: Hanft
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002648:Child; D003693:Delirium / Q000188:drug therapy* / Q000209:etiology; D020927:Dexmedetomidine / Q000627:therapeutic use; D003987:Dibenzothiazepines / Q000627:therapeutic use; D006801:Humans; D008550:Melatonin / Q000627:therapeutic use; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D020927:Dexmedetomidine; D008550:Melatonin; D018967:Risperidone; D000077152:Olanzapine