Antipsychotics offered little to no benefit when used to treat and prevent delirium in adults, according to new research. 

Investigators with Johns Hopkins recently conducted two separate systematic reviews that evaluated the benefits and harms of antipsychotics to treat and prevent delirium in adults. 

In the first review, researchers used data from 16 randomized controlled trials that compared antipsychotics to a placebo, along with data from 10 observational studies reporting harms, for treating delirium. 

The review found that there was no difference in sedation status, delirium duration, hospital length of stay or mortality between haloperidol and second-generation antipsychotics when compared to a placebo drug. Additionally, data showed there was no difference in delirium severity and cognitive functioning. 

Researchers also noted “little evidence” of an association between neurological harms and short-term use of antipsychotics for treating delirium. However, they also said potentially harmful cardiac effects tended to occur more frequently. 

“Current evidence does not support routine use of haloperidol or second-generation antipsychotics to treat delirium in adult inpatients,” the authors concluded.

The second review used data from 14 randomized controlled trials that compared haloperidol to a placebo for preventing delirium. Researchers found no differences between the drugs in delirium incidence or duration, hospital length of stay and mortality between the drugs when used for delirium prevention. Additionally, little to no evidence was found to determine the effect of haloperidol on cognitive function, delirium severity, inappropriate continuation and sedation.

“Current evidence does not support routine use of haloperidol or second-generation antipsychotics for prevention of delirium. There is limited evidence that second-generation antipsychotics may lower the incidence of delirium in postoperative patients, but more research is needed,” authors concluded.

The reviews were published Tuesday in the Annals of Internal Medicine. Both were primarily funded by the Agency for Healthcare Research and Quality.

Numerous campaigns have been undertaken to reduce antipsychotic use in nursing homes, with recent data showing that its use in long-stay residents has dropped nearly 40% since 2011. Last month, Rep. Richard Neal (D-MA) in a letter asked long-term care pharmacists to help monitor and reduce antipsychotic use in nursing homes.