title: Melatonin and melatonin agonist for delirium in the elderly patients.
abstract: The objective of this review is to summarize the available data on the use of melatonin and melatonin agonist for the prevention and management of delirium in the elderly patients from randomized controlled trials (RCTs). A systematic search of 5 major databases PubMed, MEDLINE, PsychINFO, Embase, and Cochrane Library was conducted. This search yielded a total of 2 RCTs for melatonin. One study compared melatonin to midazolam, clonidine, and control groups for the prevention and management of delirium in individuals who were pre- and posthip post-hip arthroplasty. The other study compared melatonin to placebo for the prevention of delirium in older adults admitted to an inpatient internal medicine service. Data from these 2 studies indicate that melatonin may have some benefit in the prevention and management of delirium in older adults. However, there is no evidence that melatonin reduces the severity of delirium or has any effect on behaviors or functions in these individuals. Melatonin was well tolerated in these 2 studies. The search for a melatonin agonist for delirium in the elderly patients yielded 1 study of ramelteon. In this study, ramelteon was found to be beneficial in preventing delirium in medically ill individuals when compared to placebo. Ramelteon was well tolerated in this study.
authors.affiliation: The Division of Gerontology, Geriatrics and Palliative Care, University of Alabama School of Medicine, Birmingham, AL, USA.
authors.forename: Dwaipayan
authors.initials: D
authors.lastname: Chakraborti
authors.affiliation: Behavioral Health Service, Saint Francis Hospital and Medical Center, Hartford, CT, USA.
authors.forename: Deena J
authors.initials: DJ
authors.lastname: Tampi
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA Adult Psychiatry Residency, Regional Academic Health Center, Harlingen, TX, USA tampi@uthscsa.edu.
authors.forename: Rajesh R
authors.initials: RR
authors.lastname: Tampi
mesh_terms: D000368:Aged; D003693:Delirium / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D007192:Indenes / Q000627:therapeutic use*; D008550:Melatonin / Q000819:agonists / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D007192:Indenes; C495910:ramelteon; D008550:Melatonin
keywords: delirium; melatonin; melatonin agonist; ramelteon; randomized controlled trials