Agitated delirium

Excited delirium, also known as agitated delirium, is a condition that presents with psychomotor agitation, delirium, and sweating. It may include attempts at violence, unexpected strength, and very high body temperature. Complications may include rhabdomyolysis or high blood potassium. Excited delirium, also known as agitated delirium, is a condition that presents with psychomotor agitation, delirium, and sweating. It may include attempts at violence, unexpected strength, and very high body temperature. Complications may include rhabdomyolysis or high blood potassium. The cause is often related to long term drug use or mental illness. Commonly involved drugs include cocaine, methamphetamine, or certain substituted cathinones. In those with mental illness, rapidly stopping medications such as antipsychotics may trigger the condition. The underlying mechanism is believed to involve dysfunction of the dopamine system in the brain. The diagnosis is recognized by the American College of Emergency Physicians but is not in the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases. Treatment initially includes medications to sedate the person such as ketamine or midazolam and haloperidol injected into a muscle. Rapid cooling may be required in those with high body temperature. Other supportive measures such as intravenous fluids and sodium bicarbonate may be useful. The risk of death among those affected is less than 10%. If death occurs it is typically sudden and cardiac in nature. How frequently cases occur is unknown. Males are affected more often than females. Those who die from the condition are typically male with an average age of 36. Often law enforcement has used tasers or physical measures in these cases. A similar condition was described in the 1800s and was referred to as 'Bell's mania'. The term 'excited delirium' did not come into use until the 1980s. The signs and symptoms for excited delirium may include: Excited delirium occurs most commonly in males with a history of serious mental illness or acute or chronic drug abuse, particularly stimulant drugs such as cocaine and MDPV. Alcohol withdrawal or head trauma may also contribute to the condition. A majority of fatal cases involved men. People with excited delirium commonly have acute drug intoxication, generally involving PCP, methylenedioxypyrovalerone (MDPV), cocaine, or methamphetamine. Other drugs that may contribute to death are antipsychotics. The pathophysiology of excited delirium is unclear, but likely involves multiple factors. These may include positional asphyxia, hyperthermia, drug toxicity, and/or catecholamine-induced fatal abnormal heart rhythms. Other medical conditions that can resemble excited delirium are panic attacks, hyperthermia, diabetes, head injury, delirium tremens, and hyperthyroidism.