Central Nervous System (CNS) Medications and Delirium

Abstract

Delirium is a condition of acute and reversible confusion characterized by fluctuation, inattention, disorganized thinking, and an altered level of consciousness. The instrument most commonly used to assess delirium in the acute setting is the confusion assessment method or CAM. The CAM has been validated against geriatric psychiatrists' ratings using DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised; American Psychiatric Association [APA] 1987) criteria and has been shown to have sensitivity between 94% and 100% and specificity between 90% and 95% (Inouye et al. 1990). It is based on DSM-III (APA 1980) and DSM-IV (APA 1994) criteria for delirium (Table 1) and assesses four features of delirium: