Psychiatric Quarterly

, Volume 80, Issue 1, pp 23–40

Delirious Mania and Malignant Catatonia: A Report of 3 Cases and Review

  • Mark B. Detweiler
  • Abhishek Mehra
  • Thomas Rowell
  • Kye Y. Kim
  • Geoffrey Bader
Original Paper

DOI: 10.1007/s11126-009-9091-9

Cite this article as:
Detweiler, M.B., Mehra, A., Rowell, T. et al. Psychiatr Q (2009) 80: 23. doi:10.1007/s11126-009-9091-9

Abstract

Delirious mania is often difficult to distinguish from excited catatonia. While some authors consider delirious mania a subtype of catatonia, the distinction between the two entities is important as treatment differs and effects outcome. It appears that as catatonia is described as having non-malignant and malignant states, the same division of severity may also apply to delirious mania. Non-malignant delirious mania meets the criteria for mania and delirium without an underlying medical disorder. The patients are amnestic, may lose control of bowel and bladder, but still respond to atypical antipsychotics and mood stabilizers. However, with increasing progression of the disease course and perhaps with an increasing load of catatonic features, delirious mania may convert to a malignant catatonic state (malignant delirious mania) which is worsened by antipsychotics and requires a trial of benzodiazepines and/or ECT. Three case reports are presented to illustrate the diagnostic conundrum of delirious mania and several different presentations of malignant catatonia.

Keywords

Delirious maniaCatatoniaMalignant catatoniaNeuroleptic malignant syndromeAtypical antipsychotics

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Mark B. Detweiler
    • 1
    • 2
  • Abhishek Mehra
    • 3
  • Thomas Rowell
    • 3
  • Kye Y. Kim
    • 1
    • 2
  • Geoffrey Bader
    • 1
    • 2
  1. 1.Psychiatry ServiceVeterans Affairs Medical CenterSalemUSA
  2. 2.Department of Psychiatry and Neurobehavioral SciencesThe University of Virginia CharlottesvilleUSA
  3. 3.Carilion-University of Virginia Roanoke-Salem Psychiatric Medicine Residency ProgramUniversity of VirginiaSalemUSA