Pharmacologic Management of End-of-Life Delirium: Translating Evidence into Practice.
Journal
Cancers
Journal Volume
16
Journal Issue
11
ISSN
2072-6694
Date Issued
2024-05-28
Author(s)
Abstract
End-of-life delirium affects a vast majority of patients before death. It is highly distressing and often associated with restlessness or agitation. Unlike delirium in other settings, it is considered irreversible, and non-pharmacologic measures may be less feasible. The objective of this review is to provide an in-depth discussion of the clinical trials on delirium in the palliative care setting, with a particular focus on studies investigating pharmacologic interventions for end-of-life delirium. To date, only six randomized trials have examined pharmacologic options in palliative care populations, and only two have focused on end-of-life delirium. These studies suggest that neuroleptics and benzodiazepines may be beneficial for the control of the terminal restlessness or agitation associated with end-of-life delirium. However, existing studies have significant methodologic limitations. Further studies are needed to confirm these findings and examine novel therapeutic options to manage this distressing syndrome.
Subjects
antipsychotic agents
benzodiazepines
death
delirium
drug therapy
neoplasms
palliative care
randomized controlled trial
terminally ill
SDGs
Type
journal article