• Determination of best pharmacological treatment
  • It remains unclear if and when second-generation antipsychotics are to be preferred over first-generation antipsychotics
  • RCT of amisulpride should be performed (see reference below)
  • Currently, there are no clear indications for the pharmacological prevention of delirium
• Identification of biomarkers that could aid in detection and diagnosis of delirium (including subclinical delirium)
• Comparing efficacy of pharmacologic treatment in certain delirium subtypes (hyperactive versus hypoactive delirium).
• Identification of elements of underlying pathophysiology of delirium and its symptoms
• Further development of prevention and detection strategies and their impact on incidence, mortality, morbidity, and cost
• Identification of elements of psychiatric consultation that have the most impact on clinical and financial outcomes of delirium prevention and treatment
• Development of a new practice guideline that incorporate recent research findings

Reference

Pintor, L, Fuente, E, Bailles, E, Matrai. S. Study on the efficacy and tolerability of amisulpride in medical/surgical inpatients with delirium admitted to a general hospital. European Psychiatry 2009;24:450-455.

Open label prospective study of 40 hospital inpatients with delirium treated with amisulpride 200-300mg/day for 1 week. Patients treated with amisulpride showed significant improvement in DRS, PANSS and MMSE.