{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:15:50Z","timestamp":1788419750257,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Drug-induced delirium is a clinically important and potentially preventable adverse event, especially in older adults, yet large-scale cross-national pharmacovigilance evidence remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis using three major spontaneous reporting systems: the FDA Adverse Event Reporting System (FAERS, 2004\u2013Q3 2025), the Japanese Adverse Drug Event Report (JADER, 2004\u2013Q2 2025), and the Canada Vigilance Adverse Reaction database (CVAR, 2004\u2013Q3 2025). Delirium cases were identified using five pre-specified Preferred Terms (PTs) selected from the narrow scope of the Standardised MedDRA Query (SMQ) Noninfectious encephalopathy\/delirium. Disproportionality analyses were performed using reporting odds ratio, proportional reporting ratio, and empirical Bayes geometric mean, with signal strength defined by lower confidence bounds. Time-to-onset (TTO) was summarized using medians, IQRs, and early-onset proportions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 263,327 reports were identified (FAERS: 243,572; JADER: 7,512; CVAR: 12,243). Delirium was more frequently reported in females (49%\u201357%) and individuals aged \u226560\u00a0years (55%\u201370%). Strong and consistent signals were observed for nervous system drugs, particularly psycholeptics, analgesics, and psychoanaleptics. Duloxetine, lamotrigine, pregabalin, quetiapine fumarate, and zolpidem demonstrated consistent signals across databases. Additional signals involved antipsychotics, benzodiazepines, opioids, and selected anti-infective agents. Time-to-onset analysis demonstrated early-onset clustering, suggesting an acute temporal pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cross-database consistency in drug class signals and early-onset temporal patterns highlights the need for medication review and risk mitigation in high-risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1878501","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:40:08Z","timestamp":1788417608000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross national pharmacovigilance analysis of drug-induced delirium: a comparative study using the US FAERS, Japanese JADER, and canadian CVAR datasets"],"prefix":"10.3389","volume":"17","author":[{"given":"Jinghua","family":"Jiao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The Affiliated Panyu Central Hospital, Guangzhou Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People\u2019s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shanghai Pudong New Area People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingpeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shanghai Pudong New Area People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Shanghai Pudong New Area People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1177\/0957154X07076467","article-title":"A brief review of the history of delirium as a mental disorder","volume":"18","author":"Adamis","year":"2007","journal-title":"Hist. 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