🎉 Save the Date: Our Annual #ADS2026Denver Social Event & Gala Alert! Join us on Sunday, June 14, at Flight Club Denver for a fun kickoff social event featuring fantastic networking, delicious food, and a game of darts! 🎯 Also, don't miss the 3rd Annual ADS Gala on

📣 Calling all #delirium superheroes! 📣 Submit your sessions for @AmerDelirium 2026!

A news article reviewing changes in the new @APApsychiatric "Practice Guideline for the Prevention and Treatment of #Delirium." 🥅 Prevention is the goal! https://t.co/LIZlZLLUXC

...so important, we repeated it, kind of. Discharge planning includes thoughtful med review, but it’s more than that. The impact of delirium often extends beyond the episode of care. Engage families, provide education and evaluate over time for lasting sequelae.

How often are meds continued thoughtlessly at transitions of care? Far. Too. Often. This is such an important statement...

As someone invested in the link between sleep & delirium, I’m underwhelmed with the data on melatonergics for delirium. For one, they’re chronobiotics, not sleeping pills. We need proper circadian-informed RCTs before we can conclude anything about melatonergics in delirium.

Wait, there's another statement on dex? Yep. Dex is magic…sort of. 🪄

A 𝐩𝐬𝐲𝐜𝐡𝐢𝐚𝐭𝐫𝐢𝐜 practice guideline is suggesting dex to prevent delirium? Do they even know what dex is? Yes, it is. Yes, we do. We follow the data. Besides, mental/cognitive health is especially important in surgical and critical care settings.

Benzos are not contraindicated in delirium. There *are* legitimate indications for benzos in delirium. There, I said it. Certainly, use caution, but don’t write them off entirely.

Delirium itself is not an indication for antipsychotics. Delirium is not an antipsychotic deficiency syndrome. One does not simply reverse delirium with antipsychotics. There is no such thing as "olanzapenia."

Antipsychotics may be used in delirium to address distressing or dangerous neuropsychiatric disturbances. Think of the behavioral & psychological symptoms of dementia as an analogy. But they’re not first line. Non-pharm approaches should be optimized first.

Non-pharm bundles prevent ~40% of delirium. That's not my conclusion. It's Cochrane's. https://t.co/gnIRH1OZFH. Non-pharm bundles should be used early and often. In the end, they represent good, humanistic care.

I’m delighted this guideline is person-forward. Not all patients are alike, and not all deliria are created equal. Tailor the workup, treatment, and overall clinical approach to each person.

Delirium is not an indication for physical restraints. Restraints should be used only as a last resort. Also, don't think of restraints as all or none. There's a huge difference between mitts & 5-points. Use the least restrictive option. And beware of biases.

Meds need be called out for their contributions to delirium. They're so often either 𝐓𝐇𝐄 or 𝐎𝐍𝐄 𝐎𝐅 𝐓𝐇𝐄 culprits. Clean up the med list where possible and definitely familiarize yourself with the Beers Criteria. https://t.co/7bW7ylkKbr

We’re not talking about the million-dollar workup for every patient. But we 𝐃𝐎 need to be thoughtful, ideally systematic, in considering a full range of relevant factors. Avoid anchoring bias, too. Always keep your eyes open for other explanations.

This is implied in the definition of “acute change” in mentation. However, don’t overlook delirium, chalking it up to baseline cognitive impairment. For your patient's sake, do the work to establish their baseline.

This first one should be uncontroversial (I hope!) One thing to bear in mind: delirium measures need to be used how they were validated. In most cases, this means 𝐃𝐄𝐋𝐈𝐁𝐄𝐑𝐀𝐓𝐄 𝐂𝐎𝐆𝐍𝐈𝐓𝐈𝐕𝐄 𝐀𝐒𝐒𝐄𝐒𝐒𝐌𝐄𝐍𝐓. None of that, “they don’t seem confused to me…”

📔 Approved in Nov 2024, the @APApsychiatric Clinical Guidelines for #delirium are now published! The statements often get the press, but don’t overlook the implementation sections. So many gems in there. 🧐 Let’s take a quick look at the statements… https://t.co/9iQreorTV3

Families: Caring for someone with #delirium is exhausting. Your wellbeing matters too. Take breaks, seek support, ask for help. #CaregiverSupport #SelfCare #DeliriumTipsforFamilies