Table 5

Principles of treatment for delirium

 1. Find the cause
2. Treat symptomatically—for example, correct fluid and electrolyte balance and nutritional status; treat infections
3. Moderate sensory balance—not too bright and noisy but not too dark
4. Spectacles; hearing aids; radio or TV; window view; night light
5. Show clock and calendar, family pictures, personal objects
6. Social support and visiting. Delusions and hallucinations should be neither endorsed nor challenged
7. Avoid drugs if possible
8. Good night's sleep
9.  Haloperidol 0.5–1.0 mg initially and can be repeated after 30 minutes. Severe agitated delirium may require doses up to 10 mg daily but this should not be used in the old or frail. These drugs should be tapered off and stopped before the patient is discharged. Benzodiazepines may be preferred when withdrawal delirium is causing agitation