Suvorexant, lemborexant may be effective in preventing delirium in critically ill adults
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Treatment with suvorexant and lemborexant may be effective for preventing delirium in critically ill adult patients, according to a study published in the Journal of Clinical Psychiatry.
“Delirium is a syndrome characterized by acute onset of deficits in attention, awareness and cognition that fluctuate in severity over a short period of time,” Ayaka Matsuoka, MD, an assistant professor in the department of emergency and critical care medicine at Saga University in Japan, and colleagues wrote. “Although effective treatment for delirium has not yet been established, preventive measures have been shown to decrease the incidence of delirium and potentially shorten its duration.
Matsuoka and colleagues sought to examine the efficacy of dual orexin receptor antagonists (DORAs) suvorexant and lemborexant in preventing delirium in critically ill patients at an advanced emergency and critical care center.
Matsuoka and colleagues’ retrospective observational study included 633 individuals aged 18 years and older, who were admitted to the emergency and critical care center at Saga University Hospital in Japan between July 2018 and November 2021. A total of 123 patients were treated with DORAs (suvorexant, n = 82; lemborexant, n = 41) and 510 participants were in the control group.
The researchers plotted Kaplan-Meier curves and performed log rank tests to compare between patients with and without DORA treatment. They also performed Cox regression analyses adjusting for factors associated with delirium.
Results showed that 236 individuals had a delirium diagnosis and 397 did not. Without adjustment, the HRs for the development of delirium were 0.56 (95% CI, 0.36–0.86) for patients treated with suvorexant and 0.26 (95% CI, 0.11–0.62) for those treated with lemborexant.
Data additionally revealed, after adjustment for delirium risk factors, the HRs remained low at 0.34 (95% CI, 0.20–0.58) for suvorexant and 0.21 (95% CI, 0.08–0.52) for lemborexant.
“Both suvorexant and lemborexant may be effective in preventing delirium in critically ill patients in advanced critical care centers,” Matsuoka and colleagues wrote.