A major U.S. study has found that an older drug called trazodone might be a safer choice than commonly used antipsychotic medications for treating delirium in seniors.
Delirium is a sudden state of confusion that often affects older adults when they are in the hospital.
It can be upsetting and dangerous, and doctors often turn to medications to manage it—even though there hasn’t been much strong evidence about which drugs are best.
This new research was published in The Lancet Healthy Longevity and looked at nationwide health data from thousands of adults aged 65 and older. All of these patients had been admitted to a hospital and later treated with medication for delirium.
The researchers compared two groups: one group received trazodone, and the other was given antipsychotic drugs like quetiapine, risperidone, or olanzapine.
The results were surprising and encouraging. The patients who took trazodone were less likely to die or return to the hospital than those who took antipsychotics. One concern with any sedating medication is the risk of falls or broken bones, but the study found no big differences between the two groups in those areas.
This means that trazodone may be a safer option for managing delirium in older adults, especially when doctors feel that medication is necessary. The researchers used a careful approach called target trial emulation.
This method helps researchers study real-world data in a way that closely matches what would be found in a randomized clinical trial, which is the gold standard for proving how well treatments work.
Experts agree that non-drug treatments, such as keeping patients calm, helping them sleep, and preventing infections, should always be the first choice. However, this study gives doctors new information that could help them choose safer medications when needed.
Dr. Dae Hyun Kim, one of the lead researchers, explained that patients who took trazodone were also less likely to be readmitted to the hospital with delirium or urinary tract infections.
Previous research has shown that antipsychotic drugs may raise the risk of urinary problems, like trouble urinating or infections, which could explain why those patients had worse outcomes in this study.
The researchers admit that more studies are needed to confirm the findings, but their work suggests that trazodone may be a better option for many older patients. This could lead to safer hospital stays and better long-term health for seniors across the country.
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