Effect of quetiapine versus haloperidol on delirium severity in hospitalized adults: A systematic review and meta‑analysis.

INTRODUCTION

Delirium is a neuropsychiatric condition, characterized by cloudy state of consciousness. Though commonly treated by haloperidol, quetiapine offers its own distinct benefits. A focused systematic review and meta-analysis was performed comparing efficacy of quetiapine with haloperidol in hospitalized adults experiencing delirium.

METHODS

According to PRISMA guidelines, PubMed, Cochrane, Embase and Google scholar were systematically searched. Only RCTs comparing quetiapine and haloperidol monotherapies on adult human patients diagnosed with delirium were included, with delirium severity as primary outcome. A random-effects model was employed for data analysis using Review Manager (RevMan).

RESULTS

3 RCTs were identified having 215 patients, with 105 receiving quetiapine and 110 receiving haloperidol (mean age ± SD: 57.25 ± 13.09, males: 57.67 %, mean follow up days ± SD: 5.75 ± 1.89). Pooled analysis showed no statistically significant differences in delirium severity (MD: -0.80, 95 % CI: [-2.05, 0.44], I² = 10 %), mortality (RR: 0.60, 95 % CI: [0.29, 1.27, I² = 0 %], sleep time (MD: 1.59, 95 % CI: [-0.45, 3.63], I² = 77 %) and response rate (RR: 0.89, 95 % CI: [0.51, 1.56], I² = 85 %).

CONCLUSION

This study shows no significant difference in overall effect of quetiapine and haloperidol in delirium management. However, due to paucity of RCTs, limited sample size and high heterogeneity, subsequent research is needed to identify optimal pharmacological interventions for delirium management.