To the Editor In their article, Hatta et al1 demonstrated that ramelteon may prevent the development of delirium. They suggested that this prophylactic effect might be mediated by the action of ramelteon on melatonin receptors 1 and 2 (MT1 and MT2) directly regulating activity of the suprachiasmatic nucleus. Two other potential mechanisms should be considered.
Howland RH. Ramelteon and the Prevention of Delirium. JAMA Psychiatry. 2014;71(10):1195. doi:10.1001/jamapsychiatry.2014.483