Abstract
Introduction: Delirium is a common and severe complication in hospitalized patients, particularly among the elderly and those in intensive care units or post-surgery. Suvorexant, a dual orexin receptor antagonist, has been proposed as a potential preventive treatment for delirium, but its safety and effectiveness have not been comprehensively analyzed. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing Suvorexant for adult delirium prevention, identified through four database searches. The primary outcome was the incidence of delirium, and the secondary outcome was the incidence of adverse events. A random-effects model was used for data synthesis. Results: Three studies, all conducted in Japan, involved 307 patients and were included in the analysis. The pooled results demonstrated that Suvorexant significantly reduced the incidence of delirium, with an Odds Ratio (OR) of 0.43 [95% Confidence Interval (CI) 0.21, 0.87, p = 0.02; I² = 16%]. A seven-day administration of Suvorexant showed a statistically significant protective effect (OR 0.50, 95% CI 0.28, 0.90, p = 0.02; I² = 0%), whereas three-day administration did not reach statistical significance (OR 0.56, 95% CI 0.24, 1.27, p = 0.16; I² = 19%). Additionally, there was no significant increase in adverse events (OR 0.91, 95%CI 0.50–1.64, p = 0.75; I² = 0%). Conclusion: Suvorexant is an effective and safe option for preventing delirium, particularly with seven-day administration periods. However, further research is required to determine the optimal dosing and duration for maximum effectiveness.
Published Version
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