Is Quetiapine Safe and Effective for Pediatric ICU Delirium? A Real-World Meta-Analysis

Pharmacy Practice

  • Noorjehan Fatah1Department of Diabetes and Endocrine, Rafha General Hospital, Northern Border Health Cluster, Saudi Arabia.
  • Hind M. AlOsaimi2Department of Pharmacy Services Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia.
  • Sarah A. Jabbari3Pharmacy Student, Faculty of Pharmacy, Jazan University, Jazan, Saudi Arabia.
  • Abeer I. Alghzwani4Department of Pharmacy, Jazan University, Jazan, Kingdom of Saudi Arabia.
  • Dareen A. Alrdaian5Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Saudi Arabia.
  • Abida Khan6Center for Health Research, Northern Border University, Arar 73213, Saudi Arabia., 7Department of Pharmaceutical Chemistry, College of Pharmacy, Northern Border University, Rafha, Saudi Arabia.
  • Shahad M. Almelihan8Department of Pharmacy, University of Hail, Hail, Saudi Arabia.
  • Ruba S. Alsalem8Department of Pharmacy, University of Hail, Hail, Saudi Arabia.
  • Badriah M. Alrashidi8Department of Pharmacy, University of Hail, Hail, Saudi Arabia.
  • Luluh Alomaym9Medical Intern, College of Medicine, University of Hail, Hail, Saudi Arabia.
  • Badr A. Alrashidi10Pharmaceutical Care Department, Northern Military Hospital, Hafar Al-Batin, Saudi Arabia.
  • Reem Q. Alshammari8Department of Pharmacy, University of Hail, Hail, Saudi Arabia.
  • Nouf K. Aldakhail11College of Pharmacy, Northern Border University, Saudi Arabia.
  • Asma M. Alshammari11College of Pharmacy, Northern Border University, Saudi Arabia.
  • Mohammed Kanan12Department of Pharmacy Services Administration, Rafha General Hospital, Northern Borders Health Cluster, Saudi Arabia.

Volume 24 Issue 2 Pages 1-22

DOI: 10.18549/PharmPract.2026.2.3261

Abstract

Background:Delirium in pediatric intensive care units (PICUs) is a significant neuropsychiatric condition that affects consciousness, attention, cognition, and perception. Its management is crucial due to its high incidence and potential severe outcomes.Objective: This review aims to evaluate the safety and efficacy of quetiapine, an atypical antipsychotic, in managing pediatric delirium within PICUs, given its prevalent use in adults and emerging application in pediatric settings.Methods: A systematic literature search was conducted across databases, including PubMed, Cochrane Library, EMBASE, and Scopus, with no restriction on publication date. Studies were selected based on their focus on the safety and efficacy of quetiapine in pediatric delirium management. Data extraction and synthesis were performed, pooling quantitative data for meta-analysis and assessing study quality and bias using standardized tools. Results: The literature search yielded six studies suitable for inclusion, encompassing randomized controlled trials and observational studies. Quetiapine was generally well tolerated, with few serious side effects, such as QTc prolongation and metabolic issues. Efficacy outcomes were mixed, with some studies reporting reduced symptoms and duration of delirium. In contrast, others indicated no significant improvement compared to other treatments or placebo.Conclusions: Quetiapine shows potential for managing pediatric delirium in PICUs, with a safety profile that is acceptable in short-term use. However, the evidence is inconclusive regarding its overall efficacy in reducing delirium incidence and duration. More robust, controlled trials are needed to establish clear guidelines and assess long-term safety and efficacy.

Keywords

  • Pediatric intensive care
  • Delirium
  • Quetiapine
  • Atypical antipsy
Pharmacy Practice

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