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Delirious Mania: Detection, Diagnosis, and Clinical Management in the Acute Setting

JACOBOWSKI, NATALIE L. MD; HECKERS, STEPHAN MD; BOBO, WILLIAM V. MD, MPH

Journal of Psychiatric Practice: January 2013 - Volume 19 - Issue 1 - p 15–28
doi: 10.1097/01.pra.0000426324.67322.06
Articles

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.

JACOBOWSKI and HECKERS: Vanderbilt University School of Medicine, Nashville, TN; BOBO. The Mayo Clinic, Rochester, MN

The authors declare no conflicts of interest.

Please send correspondence to: Natalie L. Jacobowski, MD, Vanderbilt Psychiatric Hospital, 1601 23rd Avenue South, Third Floor, Nashville, TN 37212. natalie.jacobowski@vanderbilt.edu

© 2013 Lippincott Williams & Wilkins, Inc.