A GP guide to deprescribing in delirium

Delirium is a common, distressing and serious condition in older patients that is often caused by medications.

Need to know:

  • In older patients, delirium may be the only sign of evolving medical illness and failure to recognise it may have dire consequences.
  • In the absence of a collateral history, distinguishing delirium from advanced dementia can be challenging. When in doubt assume delirium until proven otherwise and investigate accordingly.
  • Evidence does not support the use of antipsychotics for the prevention or treatment of delirium.
  • Medications are one of the most common causes of delirium and medication review should always be conducted.
  • Deprescribing centrally acting medications improves cognitive function and may reduce the risk of delirium in the future.

Delirium is an acute and fluctuating disorder of attention, awareness and cognition affecting up to 50% of older people in hospital.

Previously, delirium was considered to

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