User:Mr. Ibrahem/Hyperactive delirium with severe agitation

Hyperactive delirium with severe agitation is a condition that presents with psychomotor agitation, delirium, and sweating. It may include attempts at violence, unexpected strength, and very high body temperature. Complications may include muscle breakdown or high blood potassium.

The cause is often related to long term drug use or mental illness. Commonly involved drugs include cocaine, methamphetamine, or certain substituted cathinones. In those with mental illness, rapidly stopping medications such as antipsychotics may trigger the condition. The underlying mechanism is believed to involve dysfunction of the dopamine system in the brain. The diagnosis is recognized by the American College of Emergency Physicians but is not in the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases.

Treatment initially includes medications to sedate the person such as ketamine or midazolam and haloperidol injected into a muscle. Rapid cooling may be required in those with high body temperature. Other supportive measures such as intravenous fluids and sodium bicarbonate may be useful. The risk of death among those affected is less than 10%. If death occurs it is typically sudden and cardiac in nature.

How frequently cases occur is unknown. Males are affected more often than females. Those who die from the condition are typically male with an average age of 36. Often law enforcement has used tasers or physical measures in these cases. A similar condition was described in the 1800s and was referred to as "Bell's mania". The term "excited delirium" did not come into use until the 1980s.