Ramelteon and the Prevention of Delirium

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.