Effectiveness of melatonin in the management of delirium: A retrospective study

Background: Melatonin, a naturally occurring endogenous hormone, primarily secreted by the pineal gland plays a key role in managing multiple bodily functions which are affected among patients with delirium. In view of the same, exogenous melatonin has been evaluated in the prevention and management of delirium. Compared to the data on role of melatonin in prevention of delirium, data on the management of delirium are limited. Aim: To evaluate the effectiveness of melatonin in patients with delirium and to compare the same with haloperidol and quetiapine. Materials and Methods: Using retrospective study design, data of patients diagnosed with delirium as per the Diagnostic and Statistical Manual, 5th Revision criteria, and rated on Delirium Rating Scale-Revised 98 version at the baseline and 6 consecutive days. Results: The study included 108 patients, of whom 34 were on melatonin, 31 were on quetiapine, and 43 were on haloperidol. Findings of the present study show that melatonin is as effective as haloperidol and quetiapine in the management of delirium. Patients required 1.5–6 mg/day of melatonin, administered during the evening time. Melatonin was mostly used in patients who had prolonged QTc interval, which precluded the use of antipsychotics. Conclusion: The present study suggests that melatonin may be another pharmacological treatment option for the management of delirium, especially among patients with prolonged QTc interval.