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Treatments and drugs
By Mayo Clinic staffThe first goal of treatment for delirium is to address any underlying causes or triggering factors — by stopping use of a particular medication, for example, or treating an infection. Treatment then focuses on creating an optimal environment for healing the body and calming the brain.
Supportive care
Supportive care aims to prevent complications by protecting the airway, providing fluids and nutrition, assisting with movement, treating pain, addressing incontinence and keeping people with delirium oriented to their surroundings.
A number of simple, nondrug approaches have been found to help:
- Clocks and calendars to help a person stay oriented
- A calm, comfortable environment that includes familiar objects from home
- Regular verbal reminders of current location and what's happening
- Involvement of family members
- Avoidance of change in surroundings and caregivers
- Uninterrupted periods of sleep at night, with low levels of noise and little light
- Open blinds during the day to promote daytime alertness and a regular sleep-wake cycle
- Avoidance of physical restraints and bladder tubes
- Use of music, massage and relaxation techniques to ease agitation
- Opportunities to get out of bed, walk and perform self-care activities
- Provision of glasses, hearing aids and interpreters as needed
Medications
Drug treatment is used to calm a person only when severe agitation or confusion:
- Prevents the performance of a necessary medical exam or treatment
- Endangers the person or threatens the safety of others
- Doesn't lessen with nondrug treatments
The usual drug of choice is an antipsychotic medication, which may lessen the disorganized thinking that accompanies delirium.
- Delirium. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Dec. 8, 2009.
- Inouye SK. Delirium in older persons. New England Journal of Medicine. 2006;354:1157.
- Gleason OC. Delirium. American Family Physician. 2003;67:1027.
- Saxena S, et al. Delirium in the elderly: A clinical review. Postgraduate Medical Journal. 2009;85:405.
- Francis J, et al. Diagnosis of delirium and confusional states. http://www.uptodate.com/index.html. Accessed Dec. 8, 2009.
- Potter J, et al. The prevention, diagnosis and management of delirium in older people: Concise guidelines. Clinical Medicine. 2006;6:303.
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