{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:51:14Z","timestamp":1787241074766,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T00:00:00Z","timestamp":1614470400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychogeriatrics"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of benzodiazepines (BZDs) causes delirium, especially in elderly people. For this reason, suvorexant has been recommended as the first\u2010line hypnotic in elderly patients. The aim of this study was to determine whether the first\u2010line use of suvorexant, instead of BZDs, decreases referrals for delirium in elderly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Since May 2016 at Nagoya Ekisaikai Hospital, suvorexant has been recommended as the first\u2010line hypnotic instead of BZDs. In May 2017, suvorexant was adopted as the first\u2010line hypnotic. The number of delirium cases referred to psychiatry was compared among three consecutive periods: period A (May 2015\u2013April 2016), during which BZDs were mainly used for insomnia; period B (May 2016\u2013April 2017), during which the use of suvorexant was recommended instead of BZDs; and period C (May 2017\u2013April 2018), during which suvorexant was principally adopted as the first\u2010line hypnotic for insomnia. Potential confounding factors that may affect the development of delirium were also examined during the three periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The number of delirium referral cases in elderly patients in each period decreased, from 133 in period A to 86 in period B and 53 in period C. The rate of delirium referral cases decreased significantly every year (\n                      <jats:italic>P<\/jats:italic>\n                      = 9.02\u2009\u00d7\u200910\n                      <jats:sup>\u221210<\/jats:sup>\n                      ). Almost no significant confounding factors other than hypnotics were detected during the three periods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The referrals for delirium in elderly patients decreased significantly after the hypnotic was changed from BZDs to suvorexant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psyg.12672","type":"journal-article","created":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T20:13:50Z","timestamp":1614543230000},"page":"324-332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Significant decrease in delirium referrals after changing hypnotic from benzodiazepine to suvorexant"],"prefix":"10.1111","volume":"21","author":[{"given":"Masako","family":"Tachibana","sequence":"first","affiliation":[{"name":"Department of Psychiatry Nagoya Ekisaikai Hospital  Nagoya Japan"},{"name":"Department of Psychiatry Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8427-5639","authenticated-orcid":false,"given":"Toshiya","family":"Inada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Nagoya University Graduate School of Medicine  Nagoya Japan"},{"name":"Department of Psychobiology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Ichida","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Nagoya Ekisaikai Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihori","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Nagoya Ekisaikai Hospital  Nagoya 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