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Melatonergic agents in the prevention of delirium: A network meta-analysis of randomized controlled trials
Yang,Chun Pai1,2; Tseng,Ping Tao3,4,5; Pei-Chen Chang,Jane6,7; Su,Huanxing8; Satyanarayanan,Senthil Kumaran7,8; Su,Kuan Pin7,9
2020-04-01
Source PublicationSleep Medicine Reviews
ISSN1087-0792
Volume50
AbstractDisruption of the sleep-wake cycle is a risk factor and a prodromal indicator of delirium. Melatonergic agents may thus play a role in the prevention of delirium. Based upon literature search on eight databases, this systemic review and frequentist model network meta-analysis (NMA) aimed to determine the efficacy and tolerability of melatonergic agents in delirium prevention. Six randomized controlled trials (RCTs) were included with a total of 913 adult participants (mean age = 78.8, mean female proportion = 59.4%) investigating the preventive effects of melatonergic agents in patients with high risks of developing delirium. The outcomes of NMA demonstrated significant preventive effects with 5 mg/day of melatonin [Odds Ratio (OR) = 0.21, 95% Confidence Intervals (CIs): 0.07 to 0.64], melatonin (0.5 mg/d) [OR = 0.16 (95% CIs: 0.03 to 0.75)], and ramelteon (8 mg/d) [OR = 0.28 (95% CIs: 0.12 to 0.65)] against placebo groups. According to the surface under the cumulative ranking curve (SUCRA), 0.5 mg/d of melatonin was associated with the best preventive effect. Our findings provided the rationale for recommending low-dose melatonergic agents for delirium prevention in the practice guidelines.
KeywordDelirium Melatonin Melatonin agonist Prevention Ramelteon
DOI10.1016/j.smrv.2019.101235
URLView the original
Language英语
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Cited Times [WOS]:9   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionUniversity of Macau
Affiliation1.Department of Neurology,Kuang Tien General Hospital,Taichung,Taiwan
2.Department of Nutrition,Huang-Kuang University,Taichung,Taiwan
3.WinShine Clinics in Specialty of Psychiatry,Kaohsiung,Taiwan
4.Prospect Clinic for Otorhinolaryngology & Neurology,Kaohsiung,Taiwan
5.Institute of Biomedical Sciences,National Sun Yat-sen University,Kaohsiung,Taiwan
6.Department of Psychological Medicine,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London,United Kingdom
7.Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab),China Medical University Hospital,Taichung,Taiwan
8.State Key Laboratory of Quality Research in Chinese Medicine,Institute of Chinese Medical Sciences,University of Macau,China
9.College of Medicine,China Medical University,Taichung,Taiwan
Recommended Citation
GB/T 7714
Yang,Chun Pai,Tseng,Ping Tao,Pei-Chen Chang,Jane,et al. Melatonergic agents in the prevention of delirium: A network meta-analysis of randomized controlled trials[J]. Sleep Medicine Reviews,2020,50.
APA Yang,Chun Pai,Tseng,Ping Tao,Pei-Chen Chang,Jane,Su,Huanxing,Satyanarayanan,Senthil Kumaran,&Su,Kuan Pin.(2020).Melatonergic agents in the prevention of delirium: A network meta-analysis of randomized controlled trials.Sleep Medicine Reviews,50.
MLA Yang,Chun Pai,et al."Melatonergic agents in the prevention of delirium: A network meta-analysis of randomized controlled trials".Sleep Medicine Reviews 50(2020).
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