title: Delirious mania:  detection, diagnosis, and clinical management in the acute setting.
abstract: Delirious 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.
authors: JACOBOWSKI and HECKERS: Vanderbilt University School of Medicine, Nashville, TN, USA. natalie.jacobowski@vanderbilt.edu
authors: Natalie L
authors: NL
authors: Jacobowski
authors: Stephan
authors: S
authors: Heckers
authors: William V
authors: WV
authors: Bobo
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D002389:Catatonia / Q000175:diagnosis; D003693:Delirium / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008140:Lorazepam / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000175:diagnosis; D012307:Risk Factors
chemical_list: D006993:Hypnotics and Sedatives; D008140:Lorazepam