Evaluation of suvorexant and lemborexant for the prevention of delirium in adult critically ill patients at an advanced critical care center

The Journal of Clinical PsychiatryScott Cunningham MD PhD, et al. | November 08, 2022



Based on the ABCDEF bundle, “D” represents delirium, the incidence of which can be decreased by improving the quality of sleep.

Orexin promotes wakefulness, and as clearly shown in the current study, the dual orexin receptor antagonists, suvorexant and lembrorexant, significantly reduced the incidence of delirium, presumably by improving the quality of sleep.

This was a retrospective observational study involving patients > 18 years of age who were hospitalized > 72 h in a critical care facility. The incidence of delirium was compared between patients who were and were not treated with a dual orexin receptor antagonist.

Of the 633 patients enrolled in the study, 82 were treated with suvorexant and 41 were treated with lembrorexant.

The hazard ratios for developing delirium were 0.56 and 0.26, respectively. After adjusting for delirium risk factors, the hazard ratios for developing delirium were 0.34 and 0.21, respectively.