Excited Delirium

Excited delirium is a condition that manifests as a combination of delirium, psychomotor agitation, anxiety, hallucinations, speech disturbances, disorientation, violent and bizarre behavior, insensitivity to pain, elevated body temperature, and superhuman strength. Excited delirium is sometimes called excited delirium syndrome if it results in sudden death (usually via cardiac or respiratory arrest), an outcome that is sometimes associated with the use of physical control measures, including police restraint and tasers. Excited delirium arises most commonly in male subjects with a history of serious mental illness and/or acute or chronic drug abuse, particularly stimulant drugs such as cocaine. Alcohol withdrawal or head trauma may also contribute to the condition.

The diagnosis of excited delirium has been controversial. Excited delirium has been listed as a cause of death by some medical examiners for several years, mainly as a diagnosis of exclusion established on autopsy. Additionally, academic discussion of excited delirium has been largely confined to forensic science literature, providing limited documentation about patients that survive the condition. These circumstances have led some civil liberties groups to question the cause of death diagnosis, claiming that excited delirium has been used to "excuse and exonerate" law enforcement authorities following the death of detained subjects, a possible "conspiracy or cover-up for brutality" when restraining agitated individuals. Also contributing to the controversy is the role of taser use in excited delirium deaths. The American College of Emergency Physicians has officially recognized excited delirium as a unique syndrome and "rejects the theory" that excited delirium is an "invented syndrome" used to excuse or cover-up the use of excessive force by law enforcement. However, it has not been recognized as a medical or psychiatric diagnosis according to either the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) of the American Psychiatric Association or the International Classification of Diseases of the World Health Organization.