Management must include investigation and treatment of underlying causes and general supportive measures. Providing optimal levels of stimulation, re-orienting patients, education, and supporting families are important. Pharmacologic management of delirium should be considered only for specific symptoms or behaviours, eg, aggression, severe agitation, or psychosis. Only one randomized controlled trial of tranquilizer use for delirium in medically ill people has been published. Findings support the current belief that neuroleptics are superior to benzodiazepines in most cases of delirium.
Most authorities still consider haloperidol the neuroleptic of choice.
Controlled trials of the new atypical neuroleptics for treating delirium are not yet available. Benzodiazepines with relatively short half-lives, such as lorazepam, are the drugs of choice for withdrawal symptoms. It should be suspected with acute changes in behaviour. Careful investigation of the underlying cause permits appropriate management. This article has been peer reviewed.