jneuroJournal of Neurology and NeuropsychiatrycoVolume 2 Issue 2 (July-Dec)MultidisciplinaryEnglish6 Months NNY20251230NeurologyThe Role of Dual Orexin Receptor Antagonists (DORAs) in Preventing Delirium: A Meta-analysis and Systematic ReviewEnglishY3945Dulce CorpuzGregorio-TalaveraEnglishNDelirium is defined as a neurological incapacity that is acute in nature and usually subside after some time. It is one of the most serious metabolic disorders that is usuallyattributedtoawiderangeofcomplications.Deliriumhasbeenlinkedtodualorexin receptor antagonists (DORAs); medications commonly prescribed to treat insomnia. The objective of this study is to evaluate the efficacy of DORAdrugs, Suvorexant and Lemborexant in delirium prevention. Methods: We conducted a literature search on PUBMED, EMBASE, and Cochrane Library electronic databases among others from inception to September 1, 2024. Published papers on dual orexin receptor antagonists (DORA) in delirium prevention that have met the eligibility criteria were included for data extraction and quality assessment. Results: From the evaluated studies with 930 patients of who 132 were on Suvorexant and 58 on Lemborexant. We pooled this evidence and identified that the incidence of delirium is significantlylow in patients treated with Dora medications as compared to non-users. Conclusions: Dual orexin receptor antagonists were effective in preventing delirium in critically ill patients. Prospective studies are needed for confirmation of these results and evaluation of the effect of the drugs on the death rates in the hospital, their effect on the duration of stays in the ICU and the days that the patients are under mechanical ventilation.EnglishDual Orexin receptor antagonist; Suvorexant and lemborexant; prevention of deliriumhttps://jneuro.clsconf.com/admin/abstract?id=34References16191. Inouye, S.K. 2006. Delirium in older persons. N. Engl. J. Med. 354: 1157and;ndash;1165. https://doi.org/10.1056/NEJMra052321.2. Michaud, L.; Bula, C.; Berney, A.; et al. 2007. Delirium: Guidelines for general hospitals. J. Psychosom. Res. 62: 371and;ndash;383.and;nbsp;https://doi.org/10.1016/j.jpsychores.2006.10.004.1603. van den Boogaard, M.; Schoonhoven, L.; Evers, A.W.; van der Hoeven, J.G.; et al. 2012. Delirium in critically ill patients: Impact onlong-term outcomes. Crit. Care Med. 40: 112and;ndash;118. https://doi.org/10.1097/CCM.0b013e31822e9fc9.4. Girard, T.D.; Jackson, J.C.; Pandharipande, P.P.; et al. 2010. Delirium as a predictor of long-term cognitive impairment. Crit. CareMed. 38: 1513and;ndash;1520. https://doi.org/10.1097/CCM.0b013e3181e47be1.1645. Inouye, S.K.; Bogardus, S.T., Jr.; Charpentier, P.A.; et al. 1999. A multicomponent intervention to prevent delirium. N. Engl. J. Med.340: 669and;ndash;676. https://doi.org/10.1056/NEJM199903043400901.6. Tamura, K.; Maruyama, T.; Sakurai, S. 2019. Preventive effect of suvorexant for postoperative delirium. Ann. Thorac. Cardiovasc.and;nbsp;Surg. 25: 26and;ndash;31. https://doi.org/10.5761/atcs.oa.18-00158.7. Hatta, K.; Kishi, Y.; Wada, K. 2017. Preventive effects of suvorexant on delirium. J. Clin. Psychiatry 78: e970and;ndash;e979.and;nbsp;https://doi.org/10.4088/JCP.16m11389.8. Terada, T.; Hirayama, T.; Sadahiro, R.; et al. 2022. Lemborexant for insomnia in patients with delirium. J. Palliat. Med. 25: 797and;ndash;801.and;nbsp;https://doi.org/10.1089/jpm.2021.0322.9. Matsuoka, A.; Tobita, S.; Sogawa, R.; Shinada, K.; Murakawa-Hirachi, T.; Shimanoe, C.; Sakamoto, Y. 2022. Evaluation ofsuvorexant and lemborexant for delirium prevention. J. Clin. Psychiatry 84: 22m14471. https://doi.org/10.4088/jcp.22m1447110. Matsuoka, A.; Sogawa, R.; Murakawa-Hirachi, T.; Mizoguchi, Y.; Monji, A.; Shimanoe, C.; Sakamoto, Y. 2023. Evaluation of DORAfor delirium prevention. Gen. Hosp. Psychiatry 83: 123and;ndash;129. https://doi.org/10.1016/j.genhosppsych.2023.03.010.11. Luetz, A.; Grunow, J.J.; Mand;ouml;rgeli, R.; et al. 2019. ICU solutions to prevent delirium. Semin. Respir. Crit. Care Med. 40: 673and;ndash;686.and;nbsp;https://doi.org/10.1055/s-0039-1698404.12. Rood, P.J.; Zegers, M.; Ramnarain, D.; Koopmans, M.; Klarenbeek, T.; Ewalds, E.; van den Boogaard, M. 2021. Nursing deliriumprevention in ICU. Am. J. Respir. Crit. Care Med. 204: 682and;ndash;691. https://doi.org/10.1164/rccm.202101-0082OC.https://doi.org/10.3390/jcm1010000Journal of Neurology and;amp; Neuropsychiatry 2024, 2, 39-4513. Stollings, J.L.; Kotfis, K.; Chanques, G.; Pun, B.T.; Pandharipande, P.P.; Ely, E.W. 2021. Delirium in critical illness. Intensive Care Med. 47: 1089and;ndash;1103. https://doi.org/10.1007/s00134-021-06503-1.14. Ardeljan, A.D.; Hurezeanu, R. 2020. Lemborexant. StatPearls. (No DOI available) 15. Xu, S.; Cui, Y.; Shen, J.; Wang, P. 2020. Suvorexant for delirium prevention: A meta-analysis. Medicine 99: e21043. https://doi.org/10.1097/MD.0000000000021043