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The active management of delirium: improving detection and treatment

David Meagher is Adjunct Professor of Clinical Neuroscience at the Health Systems Research Centre, University of Limerick and Consultant Psychiatrist at the Midwestern Regional Hospital, Limerick. He is currently Vice-President of the European Delirium Association (Email: david.meagher{at}ul.ie). Maeve Leonard is a University of Limerick Clinical Research Fellow attached to the Departments of Psychiatry and Palliative Care, HSE-West, Limerick, Ireland.

The management of delirium requires careful consideration of the potential value both of pharmacological interventions and of a range of non-drug strategies. Although placebo-controlled studies of delirium treatment are lacking, less robust evidence can still inform practice. This review makes the case for more active management of delirium on the basis of recent studies of prevention, early identification and treatment both during an episode and managing the aftermath in survivors. A drug-treatment algorithm for delirium advising how drug treatments can be tailored to the specific needs of individual patients is described.