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Delirium antipsychotic use — DGM MCQ

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HardDeliriumDelirium antipsychotic useDGM

An 87-year-old woman with delirium is trying to climb over bed rails despite reassurance. She has treated pain and hypoxia has been corrected. She is at immediate risk of harm and non-drug measures have not settled her. Current medicines include no QT prolongation on ECG. What is the most appropriate management?

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Correct answer: A — Short-term low-dose antipsychotic with ongoing review

When a delirious patient is distressed or at risk of harm despite non-drug measures, short-term low-dose antipsychotic treatment may be considered with review. Long-term use, restraint and lack of observation increase harm; benzodiazepines can worsen delirium outside specific indications such as alcohol withdrawal. Medication is a last resort after cause correction and de-escalation.

Reference: NICE CG103; BNF