Delirious mania: Detection, diagnosis, and clinical management in the acute setting

Natalie L. Jacobowski, Stephan Heckers, William V. Bobo

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)15-28
Number of pages14
JournalJournal of psychiatric practice
Issue number1
StatePublished - Jan 1 2013


  • Bell's mania
  • catatonia
  • delirious mania
  • diagnosis
  • electroconvulsive therapy
  • lorazepam
  • management
  • treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health


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