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Delirium is a common complication of severe medical illness, especially in elderly and demented patients. Melatonin has been found useful for decreasing risk for delirium, as has the melatonin-1 and -2 receptor agonist ramelteon in case reports. To learn more about using ramelteon to prevent delirium, investigators in Japan conducted a five-hospital, randomized, placebo-controlled study of ramelteon (8 mg/night) in 67 acutely ill patients (mean age, 78) hospitalized for stroke, infection, fracture, heart disease, or other illnesses.
During the 1-week study, 1 patient on ramelteon and 11 on placebo developed delirium (3% vs. 32%, P=0.003, relative risk, 0.09). The results remained significant when corrected for delirium risk factors such as a…