title: [Informed Consent and the Approval by Ethics Committees of Studies Involving the Use of Atypical Antipsychotics in the Management of Delirium].
abstract: BACKGROUND
  Delirium is an acute alteration of consciousness and cognition. Atypical antipsychotics (AA) have recently become a main part of its treatment. Studies in this population generate a series of ethical dilemmas concerning the voluntary participation of patients and their state of vulnerability since their mental faculties are, by definition, compromised.
  
  
  OBJECTIVE
  To assess whether studies with AA for the treatment of delirium obtained an approval by an ethics committee on human research (ECHR), if an informed consent (IC) was obtained, whether the IC was verbal or written, and who gave the approval to participate.
  
  
  METHODS
  Systematic review of Medline for studies of delirium where quetiapine and olanzapine were the main treatment, assessing the existence of an ECHR approval and implementation of an IC.
  
  
  RESULTS
  11 studies were identified (6 of quetiapine and 5 of olanzapine). 5 had an ECHR approval.
  
  
  CONCLUSIONS
  Most studies examining the treatment of delirium with quetiapine or olanzapine were not subject to approval by an ECHR and most of them did not obtain an IC from the patient's legal guardian. It is essential that future studies of antipsychotics and other drugs for the treatment of delirium have the protocol approved by an ECHR and a written IC signed by the patient's legal representative, since by definition delirium is a condition that compromises superior mental processes.
authors.affiliation: Médico psiquiatra, Universidad de Costa Rica, San José, Costa Rica. Especialista en Psiquiatría de Enlace, Pontificia Universidad Javeriana, Bogotá, Colombia. Médico asistente especialista del Hospital Nacional de Geriatría y Gerontología. Profesor de la Universidad de Costa Rica. San José, Costa Rica. Electronic address: ricardo.millangonzalez@ucr.ac.cr.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Millán-González
keywords: Delirium; Delírium; comités de ética; consentimiento informado; ethicscommittees; informed consent; olanzapina; olanzapine; quetiapina; quetiapine