Cochrane · systematic review · CD004770
Drug therapy for delirium in terminally ill adults
Finucane, AM, Jones, L, Leurent, B, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Pain, Palliative and Supportive CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
40
current version
GRADE rated
21
No studies
19
Included studies
NR
No studies 19 · 47.5%Ungraded 0 · 0%Very low 11 · 27.5%Low 9 · 22.5%Moderate 1 · 2.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: haloperidol compared with placebo for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hoursa Summary of findings: haloperidol vs placebo | MD 0.34 | 1 study · 133 participants | Low Downgraded: risk of bias, imprecision |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: haloperidol vs placebo | MD 0.49 | 1 study · 123 participants | Low Downgraded: risk of bias, imprecision |
Agitation within 24 hours Summary of findings: haloperidol vs placebo | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hoursc Summary of findings: haloperidol vs placebo | no estimate extracted | 1 study · 123 participants | Low Downgraded: risk of bias, imprecision |
Adverse events including extrapyramidal effectse Summary of findings: haloperidol vs placebo | MD 0.79 | 1 study · 123 participants | Moderate Downgraded: risk of bias, imprecision |
Summary of findings: haloperidol compared with risperidone for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hoursa Summary of findings: haloperidol vs risperidone | no estimate extracted | 1 study · 126 participants | Low Downgraded: risk of bias, imprecision |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: haloperidol vs risperidone | no estimate extracted | 1 study · 106 participants | Low Downgraded: risk of bias, imprecision |
Agitation within 24 hours Summary of findings: haloperidol vs risperidone | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hours Summary of findings: haloperidol vs risperidone | no estimate extracted | NR | No studies |
Adverse events including extrapyramidal effects Summary of findings: haloperidol vs risperidone | no estimate extracted | NR | No studies |
Summary of findings: haloperidol compared with olanzapine for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hoursa Summary of findings: haloperidol vs olanzapine | MD 2.36 | 1 study · 28 participants | Very low |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: haloperidol vs olanzapine | MD 1.9 | 1 study · 24 participants | Very low |
Agitation within 24 hours Summary of findings: haloperidol vs olanzapine | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hours Summary of findings: haloperidol vs olanzapine | no estimate extracted | NR | No studies |
Adverse events including extrapyramidal effects Summary of findings: haloperidol vs olanzapine | no estimate extracted | NR | No studies |
Summary of findings: risperidone compared with placebo for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hoursa Summary of findings: risperidone vs placebo | MD 0.76 | 1 study · 129 participants | Low Downgraded: risk of bias, imprecision |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: risperidone vs placebo | MD 0.85 | 1 study · 111 participants | Low Downgraded: risk of bias, imprecision |
Agitation within 24 hoursc Summary of findings: risperidone vs placebo | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hoursc Summary of findings: risperidone vs placebo | no estimate extracted | 1 study · 111 participants | Low Downgraded: risk of bias, imprecision |
Adverse events including extrapyramidal effectsd Summary of findings: risperidone vs placebo | MD 0.73 | 1 study · 111 participants | Low Downgraded: risk of bias, imprecision |
Summary of findings: lorazepam plus haloperidol compared with placebo plus haloperidol for delirium in terminally ill adults
Population: terminally ill adults with severe delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hoursa Summary of findings: lorazepam plus haloperidol vs placebo plus haloperidol | MD 2.1 | 1 study · 50 participants | Very low |
Symptoms of delirium between 24 and 48 hours Summary of findings: lorazepam plus haloperidol vs placebo plus haloperidol | no estimate extracted | NR | No studies |
Agitation within 24 hoursc Summary of findings: lorazepam plus haloperidol vs placebo plus haloperidol | MD 1.9 | 1 study · 52 participants | Very low |
Agitation between 24 and 48 hoursc Summary of findings: lorazepam plus haloperidol vs placebo plus haloperidol | no estimate extracted | NR | No studies |
Adverse events including extrapyramidal effectsd Summary of findings: lorazepam plus haloperidol vs placebo plus haloperidol | RR 0.7 | 1 study · 31 participants | Very low |
Summary of findings: haloperidol compared with chlorpromazine for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hours Summary of findings: haloperidol vs chlorpromazine | no estimate extracted | NR | No studies |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: haloperidol vs chlorpromazine | MD 0.37 | 1 study · 24 participants | Very low |
Agitation within 24 hours Summary of findings: haloperidol vs chlorpromazine | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hours Summary of findings: haloperidol vs chlorpromazine | no estimate extracted | NR | No studies |
Adverse events including extrapyramidal effectsc Summary of findings: haloperidol vs chlorpromazine | MD 0.46 | 1 study · 24 participants | Very low |
Summary of findings: haloperidol compared with lorazepam for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hours Summary of findings: haloperidol vs lorazepam | no estimate extracted | NR | No studies |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: haloperidol vs lorazepam | no estimate extracted | 1 study · 17 participants | Very low |
Agitation within 24 hours Summary of findings: haloperidol vs lorazepam | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hours Summary of findings: haloperidol vs lorazepam | no estimate extracted | NR | No studies |
Adverse events including extrapyramidal effectsc Summary of findings: haloperidol vs lorazepam | no estimate extracted | 1 study · 16 participants | Very low |
Summary of findings: lorazepam compared with chlorpromazine for delirium in terminally ill adults
Population: terminally ill adults with delirium
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Symptoms of delirium within 24 hours Summary of findings: lorazepam vs chlorpromazine | no estimate extracted | NR | No studies |
Symptoms of delirium between 24 and 48 hoursa Summary of findings: lorazepam vs chlorpromazine | MD 5.25 | 1 study · 19 participants | Very low |
Agitation within 24 hours Summary of findings: lorazepam vs chlorpromazine | no estimate extracted | NR | No studies |
Agitation between 24 and 48 hours Summary of findings: lorazepam vs chlorpromazine | no estimate extracted | NR | No studies |
Number of adverse events including extrapyramidal effectsc Summary of findings: lorazepam vs chlorpromazine | MD 7.12 | 1 study · 18 participants | Very low |