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).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Revision. Washington, DC: American Psychiatric Association, 2000.
Di Maio T.G. and Di Maio V.J.M. Excited Delirium Syndrome. Boca Raton, FL: CRC Press Inc., 2006.
Bell L.V. On a Form of Disease resembling some advanced stages of mania and fever. Amer. J. Insanity 6:97ā127, 1849.
Cancro R. The Introduction of Neuroleptics: A Psychiatric Revolution. Psychiatric Services 51(3), 2000.
Lieberman J.A., Golden R., Stroup S., and McEnvoy J. Drugs of the psychopharmacological revolution in clinical psychiatry. Psychiatric Services 51(10), 2000.
Di Maio V.J.M. and Di Maio, D. Forensic Pathology, 2nd ed. Boca Raton, FL: CRC Press Inc., 2001.
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):187ā191, 2001.
Weiss S. and Baker J.P. The carotid sinus reflex in health and disease. Medicine 12:297ā354, 1933.
Thomas J.E. Hyperactive carotid sinus reflexes and carotid sinus syncope. Mayo Clinic. Proc. 44:127ā139,1969.
Walter P.F., Crawley I.S., and Dorney E.R. Carotid sinus hyppersensitivity and syncope. Amer. J. Cardiology. 42: 396ā403, 1978.
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):16ā18, 1988.
OāHalloran R.L. and Lewman L.V. Restraint asphyxiation in excited delirium. Am. J. Forensic Med. Pathol. 14(4):289ā295, 1993.
Chan T.C., Vilke G.M., Neuman T., and Clausen L. Restraint positional asphyxia. Ann. Emerg. Med. 1997;30(5):578ā586.
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):171ā175, 2007.
Guyton A.C. and Hall J.E. Medical physiology, 10th ed. Philadelphia: WB Saunders, 2000.
World Health Organization. Neuroscience of Psychoactive Substance Use and Dependence, 2004.
Cooper J.R., Bloom F.E., and Roth R.H. The Biochemical Basis of Neuropharmacology, 8th ed. New York: Oxford University Press, 2003.
Katz A.M. Physiology of the heart. Philadelphia, PA: Lippincott Williams & Wilkins, 2001.
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):580ā585, 1996.
Calzada B.C. and De Artinano A.A. Alpha-adrenoceptor subtypes. Pharm. Res. 44(3):195ā208, 2001.
Guimaraes S. and Moura D. Vascular adrenoceptors: an update. Pharm. Reviews. 53:319ā356, 2001.
Heusch G., Baumgart D., Camici P., et al. [alpha]- Adrenergic coronary vasoconstriction and myocardial ischemia in humans. Circulation 101(6):689ā694, 2000.
Lange R.A. and Hillis L.D. Cardiovascular complications of cocaine use. New Eng. J. Med. 345(5):351ā358, 2001.
Hajjar R.J. and MacRae C.A. EditorialāAdrenergic-receptor polymorphism and heart failure. New Eng. J. Med. 347(15):1196ā1198, 2002.
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):1135ā1142, 2002.
Dimsdale J.E., Hartley G.T., Guiney T., Ruskin J.N., and Greenblatt D. Post-exercise peril: Plasma catecholamines and exercise. JAMA 251:630ā632, 1984.
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. 304:150ā153, 1992.
Rastergar A. and Soleimani M. Hypokalaemia and hyperkalaemia. Postgrad Med J. 77:759ā764, 2001.
Gennar F.J. Current concepts: Hypokalemia (review article). New Eng. J. Med. 339(7):451ā458, 1998.
Medbo J.I. and Sejersted O.M. Plasma potassium changes with high intensity exercise. J Physiol. 421:105ā122, 1990.
Lindinger M.I. Potassium regulation during exercise and recovery in humans: implications for skeletal and cardiac muscle. J. Mol. Cell. Cardiol. 27(4):1011ā1022, 1995.
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. 148:177ā186, 1993.
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):1164ā1171, 1994.
Karch S.B., Green G.S., et al. Myocardial hypertrophy and coronary artery disease in male cocaine users. J. Forensic Sci. 40(4):591ā595, 1995.
Wiener R.S., Lockhart J.T., and Schwartz R.G. Dilated cardiomyopathy and cocaine abuse: report of two cases. Amer. J. Med. 81:699ā701, 1986.
Karch S.B. Karchās Pathology of Drug Abuse, 3rd. ed. Boca Raton, FL: CRC Press, 2002.
Silver M.D., Gotlieb A.L., and Schoen F.J. Cardiovascular Pathology. Philadelphia, PA: Churchill Livingstone, 2001.
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):1778ā1785, 2000.
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. 271:1678ā1685, 1994.
Mash D.C., Pablo J., Ouyang Q., Hearn W.L., and Izenwasser S. Dopamine transport function is elevated in cocaine users. J. Neurochem. 81:292ā300, 2002.
Billman G.E. Cocaine: a review of the toxic actions on cardiac function. Crit Rev. Toxicol. 25:113, 1995.
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):1ā13, 2000.
McCann U.D. and Ricaurte G.A. Amphetamine neurotoxicity: accomplishments and remaining challenges. Neurosci. Biobehavioral Rev. 27(8):821ā826, 2004.
Singer K. and Lundberg W.B. Ventricular arrythmias associated with the ingestion of alcohol. Ann. Intern. Med. 77:247ā248, 1972.
Ettinger P.O., Wu C.F., De La Cruz C. Jr., Weisse A.B., Ahmed S.S., and Regan T.J. Arrhythmias and the āHoliday Heartā: alcohol-associated cardiac rhythm disorders. Am. Heart J. 95(5):555ā562, 1978.
Witchel H.J., Hancox J.C., and Nutt D.J. Psychotropic drugs, cardiac arrhythmia, and sudden death. J. Clin. Psychopharmacol. 23(1):58ā77, 2003.
Roden D.M. Drug-induced prolongation of the QT interval] New Eng. J. Med. 350(10):1013ā1022, 2004.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights 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)