The researchers hope that evidence-based recommendations can be implemented into clinical practice so that delirium risk by medicine type can be determined
Older people taking a drug used to treat anxiety and insomnia as well as those on antidepressants, are twice as likely to suffer postoperative delirium after hip and knee surgery, a new Australian study has found.
The finding has prompted calls by University of South Australia (UniSA) researchers for older patients to temporarily cease these medications or change to safer alternatives prior to surgery.
In a study published in the international journal Drug Safety, UniSA scientists scanned data from 10,456 patients aged 65 years and older who had undergone knee or hip surgery in the past 20 years. A quarter of them (2614 people) had experienced delirium after surgery. Commonly prescribed medications for anxiety, seizures and insomnia were associated with delirium, although not to the same extent. They included sertraline, mirtazapine, venlafaxine, citalopram and fluvoxamine.
Lead researcher Dr Gizat Kassie says there was no link between pain-relieving opioids and delirium. “Our findings show that different classes of medicine are riskier than others when it comes to causing delirium after surgery, and the older the patients are, the greater the risk,” he says.
The researchers hope that evidence-based recommendations can be implemented into clinical practice so that delirium risk by medicine type can be determined.
“In people undergoing elective procedures it should be practical to taper specific medications well in advance. It’s important that people are weaned off these riskier drugs well before surgery because abrupt withdrawal can have even worse consequences,” Dr Kassie says.
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