Skip to main content

Delirium involves an acute (minutes to hours), transient disturbance in consciousness and cognition. It is manifested by disorientation, disorganized and inconsistent thought processes, inability to distinguish reality from hallucinations, disturbances in speech, disorientation to time and place, and misidentification of individuals [1]. When the delirium involves combative and/or violent behavior, it is termed excited delirium (ED).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision. Washington, DC: American Psychiatric Association, 2000.

    Google ScholarĀ 

  2. Di Maio T.G. and Di Maio V.J.M. Excited Delirium Syndrome. Boca Raton, FL: CRC Press Inc., 2006.

    Google ScholarĀ 

  3. Bell L.V. On a Form of Disease resembling some advanced stages of mania and fever. Amer. J. Insanity 6:97ā€“127, 1849.

    Google ScholarĀ 

  4. Cancro R. The Introduction of Neuroleptics: A Psychiatric Revolution. Psychiatric Services 51(3), 2000.

    Google ScholarĀ 

  5. Lieberman J.A., Golden R., Stroup S., and McEnvoy J. Drugs of the psychopharmacological revolution in clinical psychiatry. Psychiatric Services 51(10), 2000.

    Google ScholarĀ 

  6. Di Maio V.J.M. and Di Maio, D. Forensic Pathology, 2nd ed. Boca Raton, FL: CRC Press Inc., 2001.

    Google ScholarĀ 

  7. Stratton S.J., Rogers C., Brickett, K., and Gruzinski G. Factors associated with sudden death of individuals requiring restraint for excited delirium. Amer. J. Emerg. Med. 19(3):187ā€“191, 2001.

    ArticleĀ  CASĀ  Google ScholarĀ 

  8. Weiss S. and Baker J.P. The carotid sinus reflex in health and disease. Medicine 12:297ā€“354, 1933.

    ArticleĀ  Google ScholarĀ 

  9. Thomas J.E. Hyperactive carotid sinus reflexes and carotid sinus syncope. Mayo Clinic. Proc. 44:127ā€“139,1969.

    CASĀ  Google ScholarĀ 

  10. Walter P.F., Crawley I.S., and Dorney E.R. Carotid sinus hyppersensitivity and syncope. Amer. J. Cardiology. 42: 396ā€“403, 1978.

    ArticleĀ  CASĀ  Google ScholarĀ 

  11. Reay D.T., Howard J.D., Fligner C.L., and Ward, R.J. Effects of positional restraint on oxygen saturation and heart rate following exercise. Amer J. Forensic Med. Path. 9(1):16ā€“18, 1988.

    ArticleĀ  CASĀ  Google ScholarĀ 

  12. Oā€™Halloran R.L. and Lewman L.V. Restraint asphyxiation in excited delirium. Am. J. Forensic Med. Pathol. 14(4):289ā€“295, 1993.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  13. Chan T.C., Vilke G.M., Neuman T., and Clausen L. Restraint positional asphyxia. Ann. Emerg. Med. 1997;30(5):578ā€“586.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  14. Michalewicz B.A., Chan T.C., Vilke G.M., Levy S.S., Neuman T.S., and Kolkhorst F.W. Ventilatory and metabolic demands during aggressive physical restraint in healthy adults. J. Forensic Sci. 52(1):171ā€“175, 2007.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  15. Guyton A.C. and Hall J.E. Medical physiology, 10th ed. Philadelphia: WB Saunders, 2000.

    Google ScholarĀ 

  16. World Health Organization. Neuroscience of Psychoactive Substance Use and Dependence, 2004.

    Google ScholarĀ 

  17. Cooper J.R., Bloom F.E., and Roth R.H. The Biochemical Basis of Neuropharmacology, 8th ed. New York: Oxford University Press, 2003.

    Google ScholarĀ 

  18. Katz A.M. Physiology of the heart. Philadelphia, PA: Lippincott Williams & Wilkins, 2001.

    Google ScholarĀ 

  19. Insel PA. Seminars in medicine of the Beth Israel Hosp., Boston: Adrenergic receptors ā€“ evolving concepts and clinical implications (Review article). New Eng. J. Med. 334(9):580ā€“585, 1996.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  20. Calzada B.C. and De Artinano A.A. Alpha-adrenoceptor subtypes. Pharm. Res. 44(3):195ā€“208, 2001.

    ArticleĀ  Google ScholarĀ 

  21. Guimaraes S. and Moura D. Vascular adrenoceptors: an update. Pharm. Reviews. 53:319ā€“356, 2001.

    CASĀ  Google ScholarĀ 

  22. Heusch G., Baumgart D., Camici P., et al. [alpha]- Adrenergic coronary vasoconstriction and myocardial ischemia in humans. Circulation 101(6):689ā€“694, 2000.

    PubMedĀ  CASĀ  Google ScholarĀ 

  23. Lange R.A. and Hillis L.D. Cardiovascular complications of cocaine use. New Eng. J. Med. 345(5):351ā€“358, 2001.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  24. Hajjar R.J. and MacRae C.A. Editorialā€Adrenergic-receptor polymorphism and heart failure. New Eng. J. Med. 347(15):1196ā€“1198, 2002.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  25. Small K.M., Wagoner L.E., Levin A.M., Kardia S.L.R., and Liggett S.B. Synergistic polymorphisms of B 1 and alpha 2c adrenergic receptors and the risk of congestive heart failure. New Eng. J. Med. 347(15):1135ā€“1142, 2002.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  26. Dimsdale J.E., Hartley G.T., Guiney T., Ruskin J.N., and Greenblatt D. Post-exercise peril: Plasma catecholamines and exercise. JAMA 251:630ā€“632, 1984.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  27. Young D.B., Srivastava T.N., Fitzovich D.E., Kivlighn S.D., and Hamaguchi M. Potassium and catecholamine concentrations in the immediate post exercise period. Am. J Med. Sci. 304:150ā€“153, 1992.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  28. Rastergar A. and Soleimani M. Hypokalaemia and hyperkalaemia. Postgrad Med J. 77:759ā€“764, 2001.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  29. Gennar F.J. Current concepts: Hypokalemia (review article). New Eng. J. Med. 339(7):451ā€“458, 1998.

    ArticleĀ  Google ScholarĀ 

  30. Medbo J.I. and Sejersted O.M. Plasma potassium changes with high intensity exercise. J Physiol. 421:105ā€“122, 1990.

    PubMedĀ  CASĀ  Google ScholarĀ 

  31. Lindinger M.I. Potassium regulation during exercise and recovery in humans: implications for skeletal and cardiac muscle. J. Mol. Cell. Cardiol. 27(4):1011ā€“1022, 1995.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  32. Paterson D.J., Rogers J., Powell T., and Brown H.F. Effect of catecholamines on the ventricular myocyte action potential in raised extracellular potassium. Acta Physiologica. Scand. 148:177ā€“186, 1993.

    ArticleĀ  CASĀ  Google ScholarĀ 

  33. Leitch S.P. and Paterson D.J. Interactive effects of K+, acidosis, and catecholamines on isolated rabbit heart: implications for exercise. J. Appl. Physiol. 77(3):1164ā€“1171, 1994.

    PubMedĀ  CASĀ  Google ScholarĀ 

  34. Karch S.B., Green G.S., et al. Myocardial hypertrophy and coronary artery disease in male cocaine users. J. Forensic Sci. 40(4):591ā€“595, 1995.

    PubMedĀ  CASĀ  Google ScholarĀ 

  35. Wiener R.S., Lockhart J.T., and Schwartz R.G. Dilated cardiomyopathy and cocaine abuse: report of two cases. Amer. J. Med. 81:699ā€“701, 1986.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  36. Karch S.B. Karchā€™s Pathology of Drug Abuse, 3rd. ed. Boca Raton, FL: CRC Press, 2002.

    Google ScholarĀ 

  37. Silver M.D., Gotlieb A.L., and Schoen F.J. Cardiovascular Pathology. Philadelphia, PA: Churchill Livingstone, 2001.

    Google ScholarĀ 

  38. Spitito P., Bellone P., et al. Magnitude of left ventricular hypertrophy and risk of sudden death in hypertrophic cardiomyopathy. New Eng. J. Med. 342(24):1778ā€“1785, 2000.

    ArticleĀ  Google ScholarĀ 

  39. Staley J.K., Hearn W.L., Ruttenber A.J., Wetli C.V., and Mash D.C. High affinity cocaine recognition sites on the dopamine transporter are elevated in fatal cocaine overdose victims. J. Pharmacol. Exp. Ther. 271:1678ā€“1685, 1994.

    PubMedĀ  CASĀ  Google ScholarĀ 

  40. Mash D.C., Pablo J., Ouyang Q., Hearn W.L., and Izenwasser S. Dopamine transport function is elevated in cocaine users. J. Neurochem. 81:292ā€“300, 2002.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  41. Billman G.E. Cocaine: a review of the toxic actions on cardiac function. Crit Rev. Toxicol. 25:113, 1995.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  42. Fleckenstein A.E., Gibb J.W., Hanson G.R. Differential effects of stimulants on monoaminergic transporters: pharmacological consequences and implications for neurotoxicity. Eur. J. Pharmacol. 406(1):1ā€“13, 2000.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  43. McCann U.D. and Ricaurte G.A. Amphetamine neurotoxicity: accomplishments and remaining challenges. Neurosci. Biobehavioral Rev. 27(8):821ā€“826, 2004.

    ArticleĀ  CASĀ  Google ScholarĀ 

  44. Singer K. and Lundberg W.B. Ventricular arrythmias associated with the ingestion of alcohol. Ann. Intern. Med. 77:247ā€“248, 1972.

    PubMedĀ  CASĀ  Google ScholarĀ 

  45. Ettinger P.O., Wu C.F., De La Cruz C. Jr., Weisse A.B., Ahmed S.S., and Regan T.J. Arrhythmias and the ā€œHoliday Heartā€: alcohol-associated cardiac rhythm disorders. Am. Heart J. 95(5):555ā€“562, 1978.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  46. Witchel H.J., Hancox J.C., and Nutt D.J. Psychotropic drugs, cardiac arrhythmia, and sudden death. J. Clin. Psychopharmacol. 23(1):58ā€“77, 2003.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  47. Roden D.M. Drug-induced prolongation of the QT interval] New Eng. J. Med. 350(10):1013ā€“1022, 2004.

    CASĀ  Google ScholarĀ 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vincent J. M. Di Maio .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

Ā© 2009 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Di Maio, V.J.M., Di Maio, T.G. (2009). Excited Delirium Syndrome. In: Ho, J., Kroll, M. (eds) TASERĀ® Conducted Electrical Weapons: Physiology, Pathology, and Law. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-85475-5_28

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-85475-5_28

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-85474-8

  • Online ISBN: 978-0-387-85475-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics