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Efficacy of the Administration of Melatonin 5mg in the Prevention of Delirium in Older Adults Hospitalized in the Emergency Department

NCT04187807 — Not applicable, Unknown, 145 participants, Universidad Autonoma de San Luis Potosí

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RegistryNCT04187807
StatusUnknown
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: triple, prevention
Enrollment145 (Estimated)
SponsorUniversidad Autonoma de San Luis Potosí (Other)
ConditionsDelirium in Old Age
InterventionsMelatonin 5 mg (Drug)
Datesstart 2019-10-10, primary completion 2020-03-01 (estimated), completion 2020-05-01 (estimated), first posted 2019-12-05, last updated 2019-12-05
Locations1 site in Mexico

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-Summary

This study evaluates the efficacy of melatonin 5mg in the prevention of Delirium in the older adults in emergency department. Half of the participants will receive melatonin 5mg and the other half will use a starch-based placebo.

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+Detailed description

Melatonia is useful for the treatment of sleep disorders due to the interruption of the circadian rhythm, secondary to alterations caused by the environment. The doses of 5 to 10mg oral or sublingual can improve the quality of the sleep-wake cycle and alertness in short-term use.

Mechanism of action of melatonin are:

1. Binding to membrane receptors: MT1 and MT2 coupled to G protein
2. \- Union to nuclear receptors.
3. \- Interaction with cytosolic proteins.
4. \- Antioxidant of direct and indirect action.
5. \- Interaction with mitochondria.

Melatonin circulates 80% bound to albumin and the rest in free form in plasma, 85-90% is metabolized by 6-hydroxymelatonin in the liver, which is then conjugated with sulfuric acid (70-80%) or glucuronic ( 5-3%), and is excreted in urine and feces.

Melatonin and its metabolites act as catalytic antioxidants to safeguard mitochondrial electron transfer reactions, therefore, increases the efficiency of energy metabolism. Melatonin synthesis decreases significantly as age progresses and changes in the circadian cycle have been associated with accelerated aging.

+Arms and interventions

ArmTypeInterventionsDescription
Melatonin 5mgExperimentalDrug: Melatonin 5 mgMelatonin 5mg, every 24 hours for 14 days
PlaceboPlacebo comparatorDrug: Melatonin 5 mgStarch based placebo, every 24 hours for 14 days
  • Melatonin 5 mg (Drug), also known as Cronocaps: Placebo

+Outcome measures

Primary outcomes

  • Delirium [14 days]: Diagnosis based Confusional Assessment Method Scale

+Eligibility

Sex: All, ages: 60 Years to any

Inclusion Criteria:

* Men and women over 60 who enter the emergency department with a stay in the ward for more than 8 hours and who will remain hospitalized for more than 48 hours due to admission pathology.
* Patients who agree to participate in the study by signing an informed consent (Signature by patient and / or family member).

Exclusion Criteria:

* Patients with a history of dementia or previous neurological diseases.
* Patients with a history of psychiatric disorder.
* Patients diagnosed with any type of liver disease.
* Warfarin treatment.
* Delirium data on admission to the emergency department.
* Patients under invasive mechanical ventilation and sedation.

+Locations (1)

FacilityCityCountryStatus
Instituto Mexicano Del Seguro SocialSan Luis Potosí CityMexicoRecruiting

+Investigators

  • Antonio Gordillo, PhD, Study director, Universidad Autonoma de San Luis Potosí
  • Fatima A Sánchez, Doctor of medicine, Principal investigator, Universidad Autonoma de San Luis Potosí

My Notes