The objective of this review is to summarize the available data on the use of
melatonin and
melatonin agonist for the prevention and management of
delirium in the elderly patients from randomized controlled trials (RCTs). A systematic search of 5 major databases PubMed, MEDLINE, PsychINFO, Embase, and Cochrane Library was conducted. This search yielded a total of 2 RCTs for
melatonin. One study compared
melatonin to
midazolam,
clonidine, and control groups for the prevention and management of
delirium in individuals who were pre- and posthip post-hip
arthroplasty. The other study compared
melatonin to placebo for the prevention of
delirium in older adults admitted to an inpatient internal medicine service. Data from these 2 studies indicate that
melatonin may have some benefit in the prevention and management of
delirium in older adults. However, there is no evidence that
melatonin reduces the severity of
delirium or has any effect on behaviors or functions in these individuals.
Melatonin was well tolerated in these 2 studies. The search for a
melatonin agonist for
delirium in the elderly patients yielded 1 study of
ramelteon. In this study,
ramelteon was found to be beneficial in preventing
delirium in medically ill individuals when compared to placebo.
Ramelteon was well tolerated in this study.