Melatonin Fails to Reduce Delirium in Elderly Patients Undergoing Acute Hip Surgery

Intake of melatonin supplements does not reduce delirium in older adults undergoing acute hip surgery, a study reveals.

Delirium is defined as a serious disturbance in the mental abilities of a person that causes rapid changes in the brain functions that is linked with hallucinations and hyperactivity. The onset of delirium is sudden, often within hours or a few days. Acute conditions that trigger delirium often occur with chronic disorders that lead to dementia. It lasts for a week and takes several weeks for the mental function to return to normal.

A team of researchers from Netherlands conducted a randomized controlled trial that looked at the impact of melatonin on delirium in seniors undergoing surgery for hip fractures. They found that the supplement did not lessen delirium in the patients.

Most often antipsychotic drugs are used to lower symptoms of delirium, but they are known to causes serious adverse effects due to which the U.S. Food and Drug Administration have strictly warned against the use of these drugs. They also use Benzodiazepines that are known to cause or aggravate delirium. One of the factors underlying delirium is lack of melatonin. 

In the latest study, the researchers looked at 378 patients with mean age of 84 years. Out of these, 238 lived at home before the surgery. Out of the total number of participants, 210 had cognitive impairment. While 186 were randomly given melatonin, 192 of them received a placebo.

"We observed no effect of melatonin on the incidence of delirium," writes Dr. Annemarieke de Jonghe, Department of Internal Medicine, Geriatrics Section, Academic Medical Center, University of Amsterdam, Amsterdam, with co-authors. "The median duration of delirium was similar between the study groups. However, there was some indication that perioperative melatonin supplementation resulted in fewer patients having a long duration (> 2 days) of delirium."

The study reveals that elderly patients vulnerable to hip fracture, melatonin fails to prevent postoperative delirium. The researchers demand the need for further research to compare the effects of melatonin with antipsychotics in those with hip fractures who also have delirium.

The finding was documented in the Canadian Medical Association Journal.