• J Psychiatr Pract · Jan 2013

    Review

    Delirious mania: detection, diagnosis, and clinical management in the acute setting.

    • Natalie L Jacobowski, Stephan Heckers, and William V Bobo.
    • JACOBOWSKI and HECKERS: Vanderbilt University School of Medicine, Nashville, TN, USA. natalie.jacobowski@vanderbilt.edu
    • J Psychiatr Pract. 2013 Jan 1;19(1):15-28.

    AbstractDelirious mania is a severe but under-recognized neuropsychiatric syndrome characterized by the rapid onset of delirium, mania, and psychosis, not associated with a prior toxicity, physical illness, or mental disorder. Catatonia is often a prominent feature of the syndrome. While initially believed to be rare, recent reports suggest that delirious mania may constitute up to 15% of all acute mania cases. When delirious mania is unrecognized or improperly treated, it can progress rapidly in severity and can become life-threatening. This article reviews the pathophysiology, diagnosis, and treatment of delirious mania and includes a detailed case report. Delirious mania is robustly responsive to high-dose lorazepam or electroconvulsive therapy (ECT); thus, early recognition and definitive treatment can be life-saving.

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