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Archive 1

"Berserker-Rage" - anticholinergic substances can cause an excited delirium


"Blind as a bat, mad as a hatter, red as a beet, hot as Hades, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone." The anticholinergic mnemonic

There was a typical form of "Excited delirium" back in days called "Berserkerwut" (german). It is described that "Berserkers" were fighters who were in a delirious tantrum of rage. They felt no pain and did not recognized wounds. It seemed that these "Berserkers" had developed "superhuman powers".

(Additional information:
-- About the effects of Atropa Belladonna: At high dosage, the effects are restlessness, need to move, strong euphoria, emotional mood swings (laughing and crying), mania, anger and a possible tantrum of rage. Body manifestations are increased body temperature, increased heart rate, increased blood pressure and accelerated and deepened breathing. There is also a decreased sensitivity to pain.[1]
-- About the effects of Datura: At high doses appear strong excitement, frenzy, raving madness and a possible tantrum of rage. In a Delirium, the hallucinations are frightening and indistinguishable from reality.[2])

ANTICHOLINERGIC SUBSTANCES CAN CAUSE AN EXCITED DELIRIUM
Deliriants are f.e.: Tropan-alkaloids(Atropine, Hyoscyamine, Scopolam­ine) and anticholinergic substances like Benztropine (Cogentin), Dicloverine, Trihexyphenidyl (Artane), Oxybutynin, Tolterodine, Chlorphenamine, Diphenhydramine (Benadryl, Sominex), etc. etc.
(Additional information: Also alcohol and barbiturates can cause a delirium in high dosage or by withdrawal.)

Deliriants (anticholinergic substances) (f.e. Hyoscyamine, Dicycloverine, etc.) can cause an excited delirium by eliminating the parasympathetic nervous system in its dampening function -> acute anticholinergic syndrome (AAS): Increased body temperature, Increased heart rate, strong excitement, aggression, restlessness, irritability, rage and raving madness etc.
An anticholinergic syndrome can be caused by tropan alkaloids (f.e.: hyoscyamine), antidpressants, antipsychotics (neuroleptic), antihistamines [3]
For better understanding: anticholinergic substances make at low dosage tired, but at high dosage, when the parasympathetic system is complete blocked in its function, it creats a delirium
f.e.: the sleeping aid Sominex (Diphenhydramine):

  • low dosage (100 - 200mg) -> it makes tired
  • higher dosage (300mg - 400mg) -> it makes restless and delirious
  • high dosage (500mg - 800mg) -> it causes a delirium -> loss of control (possible "Berserker Rage")

In military experiments was used 3-Quinuclidinyl benzilate (Nato-code: BZ):
"Early central nervous system manifestations include heightened deep tendon reflexes, ataxia, incoordination, slurring of speech, dizziness and headache. Nausea, usually without vomiting, is frequent. During the first phase (1-4 hours), discomfort and apprehension are present. Extreme restlessness occurs, sometimes with involuntary clonic spasms of the extremities and birdlike flapping of the arms. Errors of speech and scattered moments of confusion may be noted."[4]
(Additional information: About how a delirious person reacts on amphetamines:
"I vividly recalled a senior officer who had swallowed a large handful of sleeping pills and was admitted to Letterman Army Hospital. He was out of danger, but also very much out of touch with reality. Grossly disoriented, he sat mumbling and picking at various objects in the bed. It was impossible to interview him so, to counteract the sleeping pills, I decided to order a hefty dose of amphetamines. This not-sobright idea turned him into a non-stop radio commentator on every disconnected subject crossing his mind."[5]
This also means:
1. (Methyl-)Amphetamines are widely ineffective by a delirious person.
2. (Methyl-)Amphetamines can not cause a delirium.)

About the deffinition of the term Anticholinergic Syndrome:
"The term central anticholinergic syndrome (CAS) describes a symptom complex, which was first mentioned by Longo in 1966. Hereby, the neurotransmitter acetylcholine plays a central role.
If the effect of the acetylcholine is blocked by anticholinergic substances, such as medicines or drugs, a range of central nervous system manifestations can result. This antagonistic effect results directly from the competitive displacement from the acetylcholine receptor or by indirect anticholinergic processes. One differentiates between peripherial and central manifestations. The following case report discusses the problem of identifying CAS, which is not unusual in emergency and intensive care medicine. Approximately 70% of all medicines (for example, tricyclic antidepressants, antihistamines, neuroleptics) used in suicide attempts have an anticholinergic substance." [6]
(Additional information: Acute Anticholinergic Syndrom (AAS) is the same as Central Anticholinergic Syndrom)

Anticholigernic Syndrome is distinguished in two different forms [7]:

1. Delirious form:
(central manifestations)

  • hyperactivity
  • excitability, restlessness
  • hallucinations
  • anxiety
  • aggressions
  • tantrum of rage

(peripherial manifestations)

  • hyperthermia
  • tachycardia

2. Comatose form:
(central manifestations)

  • psychomotor damping -> decreased vigilance -> somnolence -> coma

(peripherial manifestations)

  • seizures

Characteristical manifestations of an anticholinergic syndrome are colloquially described:
"Blind as a bat, mad as a hatter, red as a beet, hot as Hades, dry as a bone, the bowel and bladder lose their tone, and the heart runs alone."8

References:
1, 2 Raetsch C. The Encyclopedia of Psychoactive Plants: Ethnopharmacology and Its Applications. AT-Verlag; 2004. p.82, 84, 201, 278.
3 Pranger H. Neurologische Intensivmedizin: Praxisleitfaden für Neurologische Intensivstationen und Stroke Units. Georg Thieme Verlag; 2004. p.211ff. online version
4, 5 Ketchum JS. Chemical Warfare - Secrets almost forgotten; A Personal Story of Medical Testing of Army Volunteers. Authorhouse; 2006. p.46-47.
6, 7 Hochreuther S, et al. Zentral anticholinerges Syndrom (central anticholinergic syndrome). Intensivmedizin und Notfallmedizin 2010 April; Volume 47, Issue 3, pp 211-214. online version
8Stead LG, et al. First Aid for the Emergency Medicine Clerkship. 2nd ed. McGraw-Hill Professional Publishing; 2006. p.395–6

--Stefan Bach77 (talk) 00:35, 27 August 2014 (UTC)

Plagiarism/POV

This article is basically identical to the one at zarc.com (http://www.zarc.com/english/other_sprays/reports/excited_delirium.html) Apart from the copyright issues this might cause, the zarc article has obvious POV issues to be used as the sole source for this page, being that it is published by a pepper spray manufacturer. This page should probably be tagged as POV in dispute (sorry, I don't know how to do that). 140.107.169.117 01:54, 28 February 2007 (UTC)

If I helps, I went through the article and tried to re-write several portions and fix any issues that did not convey the story with adequate neutrality. If there is anything else that should be changed, go ahead and do so or say so and I'll try and fix it. -- 72.54.124.78

I reverted the article to the version before the copyrighted text was added. Modifying the content does not work well for resolving copyright issues. Unless the content is entirely rewritten, some of the content is always still unaltered, and violating copyright just "a little bit" does not make it acceptable. -- Kjkolb 12:34, 3 March 2007 (UTC)
Not to be obscene, but if you're going to remove most of the content of the page, even if it is because of copyright issues, at least leave a stub notice on it. --8472
And this doesn't seem to be a very neutral POV. --198.164.151.6 12:04, 12 March 2007 (UTC)

ACEP Recognizes Excited Delirium Syndrome

With the recent recognition of Excited Delirium Syndrome (ExDS) by the ACEP, there can be more focus on treatment rather than as a blunt instrument to use against police or care providers.

I

I invite anyone else to edit this page, as I just really threw a lot of it together based off of news articles and general information I could find on it. If anyone has better information or a better format, go nuts.

A suggestion

speaking as someone who stumbled onto this page with no prior knowledge of the concept, I found this article quite confusing due to the fact that there is no description of the proposed mechanisms that cause the deaths of the victims of excited delirium. I had to read the external article before I could understand the concept as a whole. As it is, this article just says that there it is controversial and was involved in the deaths of police restraining victims. It would be helpful if it mentioned somewhere that it's theorized the brain causes cardiac arrest - some guy —Preceding unsigned comment added by 125.238.202.95 (talk) 14:14, 26 November 2007 (UTC)

Why are the majority of Wikipedia articles so liberal and slanted? I'm sure the handful of people that have their deaths labeled as Sudden Cardiac Death Due to Excited Delirium each year are clean, healthy, normal people. There's no possibility they could have prior medical problems due to drug abuse, mental illness, or prior injury. In fact, it is very unlikely that those people being restrained and tased by police officers have been violent or dangerous to themselves or others. They probably were walking to church when the police tased and sat on them until they died for no good reason. Why not give a medical description of Excited Delerium instead of a biased forgery of an article. ?? —Preceding unsigned comment added by 66.169.189.110 (talk) 21:18, 26 November 2007 (UTC)

Well, actually, most of them are high on drugs at the time. The proposed mechanism is adrenaline overload. Supposedly if you can get them to the emergency room, there are some reasonably efficacious treatments. WhatamIdoing (talk) 23:09, 11 January 2008 (UTC)

NPOV

To maintain neutrality on this topic, I suggest that every line in the article have a reference. We should have both side of the issue present with each given its own space. --Richard Arthur Norton (1958- ) 17:56, 30 April 2007 (UTC)

Support: Although I am not particularly inclined to encourage differing "sides" on the matter carving out their own little partitioned subsections within the article. dr.ef.tymac 19:36, 30 April 2007 (UTC)

It's main cause is a rush of adrenelin, believe me I have had gone through this lots of times, either that or its a genetic defect, in that case get me an honorable death.

The only genetic defect it could be is a defect from my fathers side, possibly caused by agent orange during vietnam.

Or its because I have a lack of L-Tryptophan in my diet.

Or it was caused by my sister.

Or it was caused by Geodon withdraw.

Or it was caused by behavior modification in therapy.

Or it was caused by reverse gender rolls.

Or arguing with bad teachers.

Or getting graded down in college because of my political views.

Or it was caused by James Carvill (that man scares the crap out of me, and not because of all the people he's killed).

Good grief someone help me out here, and I don't need psychological help, I met all the goals on my goals sheet in thearapy.

Darrell Porter did not die from this, he was always a very calm and collective person when I knew him.

There is no evidence of any of this, just personal observation on my side.

Ok. You have shared your personal observation. Thank you for giving people a chance to see what you have to say. It is much better than erasing the whole page and silencing everyone else.
Just remember, before putting words in the Wikipedia article or taking words out, you need to have some evidence so people can learn more. That way, no one can blame you or discredit you saying, "He's just writing from his own personal opinion." Even if there is some misleading information in the article, it takes calm and collected research and time to reach our goal to improve it. It's not always easy, but if we cooperate, it works. Regards. dr.ef.tymac 02:40, 1 May 2007 (UTC)

No matter, I was just testing you guys(I never had any malicious intent), I have never bothered exploring this side of wikipedia so I was unaware of all of this. My experiences with the psychiatric community did happen, and I am not lying about my opservations, I should not have been on Geodon in the first place. I will stay on the front side, just paint my future a good one for me, I will add my e-mail address and my real full name to my page so people can contact me when they need me to vouch for anything. My username page is a little unorganized because it didn't save character returns, but etom needs to be in the Iraq Dinar folklore somehow so I know I can trust you guys to take care of it. Just remember, I am not a meddler nor am I an infidel. I am very convinced that all of you have something going with this wikipedia project, and you will recieve donations from me on a regular basis. I just want to stay off those psychiatric meds and sleeping pills, they scare girls away. Oh yeah and I am a man FYI. Good luck to you all, and don't get too technical on things, and don't stear away from the fundamentals. All the evidence of my psychiatric experience's are in my medical records, which remain private, but quite frankley I would not mind making them public to some people so we can put an end to some of this.

Thank You All

etom

I edited the page to remove the implication that tasering caused death ("tasered to death"). It could be a contributing factor, but the direct link hasn't been proven. —Preceding unsigned comment added by 76.67.16.177 (talk) 18:01, 5 December 2007 (UTC)

^ Please get back on Geodon, bro. Trust me. Charles35 (talk) 07:44, 25 November 2012 (UTC)

Is there a gender link?

All the people listed as being examples are men. I wonder if this is significant or just co-incidental. Is there any reliable info out there on this aspect? If so, it should be included or at least referenced. —Preceding unsigned comment added by Grandma Roses (talk • contribs) 11:44, 23 April 2008 (UTC)

I feel that there should be at least one link to Police_brutality. This article certainly implies the possibility of such. There are many ways an officer of the law can go beyond that law, and this is one of them. --82.93.172.114 (talk) 07:44, 21 July 2008 (UTC)

Thank you for your suggestion. When you feel an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes — they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to). WhatamIdoing (talk) 20:49, 22 July 2008 (UTC)

Bot report : Found duplicate references !

In the last revision I edited, I found duplicate named references, i.e. references sharing the same name, but not having the same content. Please check them, as I am not able to fix them automatically :)

  • "abc" :
    • {{cite web |url=http://abcnews.go.com/Health/story?id=2919037&page=1&CMP=OTC-RSSFeeds0312 |title=Excited Delirium: Police Brutality vs. Sheer Insanity |accessdate=2007-03-13 |publisher=[[ABCNews]] |date=2007-03-02 }}
    • {{cite web |url=http://abcnews.go.com/Health/story?id=2919037&page=1&CMP=OTC-RSSFeeds0312 |title=Excited Delirium: Police Brutality vs. Sheer Insanity |accessdate=2007-03-13 |publisher=[[ABCNews]] |date=[[March 2]], [[2007]] }}

DumZiBoT (talk) 18:46, 12 August 2008 (UTC)

 Done WhatamIdoing (talk) 04:48, 3 September 2008 (UTC)

Sudden death after arrest

This news story is interesting, and might be related (directly or indirectly) to this article, but I can't find a proper scientific paper for it. It may not have been published just yet, since it was only presented at the conference today. WhatamIdoing (talk) 04:46, 3 September 2008 (UTC)

Deaths From Excited Delirium

In an interview on CBC's The Current Calgary alderman Diane Colley-Urquhart justified expanded use of the Taser in Calgary. At one point she stated that you can die from excited delirium without the use of a Taser. Is anyone aware of anyone dying from excited delirium that didn't have some sort of physical interaction with the police? Stephen Rasku (talk) 16:36, 24 February 2009 (UTC)

Answer,

Yes there are many many cases of people dying without police being involved. I find the very first part of this entry to be badly distorted to give the view that this is something ONLY related to police. It isn't. It is just that when these incidents happen in public, police are invariably called and become involved. It's akin to saying houses burning down are the fault of firemen spraying water because they are always found to be there when the house has burned down. The confusion in the public is caused because the media only reports those occurrences that have happened in public. In fact there are numerous documented cases of people dying in places such as hospitals and psychiatric wards who clearly are exhibiting the same state, however these are not reported by the media and in fact they are seldom aware of them. There are papers written on these deaths in psychiatric wards back in the early 1800's. Interestingly there is a very similar condition that has caused sudden death in wild animals when captured (such as by game wardens or wildlife biologists). In those fields it is know as Capture Myopathy or Exertional Myopathy.'


-- Death due to "excited delirium" has not happened in the clinical psychiatric setting since the development of parenteral antypsychotics. Can you provide even one case in the last hundred years? My wife was a psychiatric nurse, I am an emergency physician. We have both seen numerous patients in acute psychosis. In a medical setting the acute psychotic is spoken to in a calming voice, and if he remains clearly hostile he is briefly restrained and a parenteral antipsychotic (e.g. haloperidol) or dissociative agent (e.g. ketamine) is administered by IM injection. The patient becomes calm and pulse oxymetry is monitored. In ther law enforcement setting tghe patient is restrained until he stops struggling and in many cases a spit hood is applied. He is then left unmonitored and later discovered unresponsive. I'm not aware of a single case in which video is available in which the cause of death was anything other than asphyxiation.Danwoodard (talk) 23:12, 25 October 2020 (UTC)

The second part of the confusion is due to the term itself, "Excited Delirium". This is a relatively modern term. Because the medical profession does not quite understand what EXACTLY is going on, there is no true medical term for it. It's like Sudden Infant Death Syndrome, or Died of Natural Causes. It's real, you know what it means and looks like, but it's not a proper medical term. Over the years, and even today, it can be labelled with several different terms and has historically been called such things as Positional Asphyxiation, Exhaustion, Sudden Exhaustive Death in Excited Manics, and so on.—Preceding unsigned comment added by Johnaevans (talk • contribs) 19:05, 1 March 2009 (UTC))

While the article states that "excited delirium" is no longer used to explain a medical condition by the Metropolitan Police, the same condition is now referred to as "Acute Behavioural Disorder". ABD is known to medical professionals, especially EMTs, etc, who deal with the public on a regular basis. As I understand it, one of the reasons for changing the term was that not enough people understood it, which may explain the (frankly unwarranted) scepticism on the other side of the Atlantic. —Preceding unsigned comment added by 158.143.138.27 (talk) 19:27, 10 March 2010 (UTC)

Of all the forms of acute behavioural disorder, excited delirium is the most extreme and potentially life threatening.--195.137.93.171 (talk) 08:54, 16 August 2016 (UTC)


The topic of the article, really, is The Social Construction of Reality, after Peter L. Berger laid out this sociological construct many years ago. I believe it the first episode of such a social process to mimic the plot and content of George Orwell's book 1984. The police of the Ministry of Truth who held up three fingers and yelled "four fingers" before applying high voltage shock to some subject in need of "education" have now emerged from the book pages and are walking up your driveway. Excited delirium as a "self evident" stand alone phenomenon would not make it into the A.P.A. Diagnostic and Statistical Manual. This is going to require the expenditure of megabucks to procure a myriad credentialed shills and whores to swear up and down the phenomenon exists, who will then run to the bank. By one tally the USA is up to 476 taser deaths as this note is written. The autopsies have all been done by police coroners. It brings new meaning to the concept of a Protection Racket.

I feel that a part of this page should be edited.

The part i feel that should be edited is

Toney Steele, was one of the first high-profile cases involving the cause of death as "excited delirium", this drug addict died in San Diego after being restrained in the back of a patrol car.[16]

I do not feel it necessary to label the victim as a drug addict. It is neither here nor there with regards to this topic. If no one changes it or offers an explanation to why it should not be changed then I will change it on my own accords. —Preceding unsigned comment added by GeneralChoomin (talk • contribs) 01:14, 1 September 2009 (UTC)

POV vs. OR -- I don't like the tone of this page.

There are a lot of OR-based edits I would like to make to this page, so I am "venting" here. I googled on "Excited delirium" because I was doing some OR. The Seattle (WA, US) police just called the medics for a man who is exhibiting signs of "excited delirium." He is in a 7-11 with a handgun, taking off his clothes, and drinking all the gatorade. He will not come outside or obey their orders. So, they have sent for officers with tasers and bean-bag shotguns in order to perhaps subdue him given the opportunity. These are what the police call "less-lethal devices." In the beginning of tonight's stand-off, there were a few tense moments during which the armed and delirious suspect might have walked out of the store while waving a gun. In that case, he would have been killed. So, the arrival of police with tasers and other less-lethal means has been a relief. Anyway, the police just called a precautionary ambulance because the person showed the signs of what the called "Excited delirium" as he began to [remove his clothes, and start drinking all the gatorade]. It sounds like they think he is going to pass out pretty soon of his own devices, and then they will have him treated. Or perhaps they are worried that they will try to tase him, if he comes outside wielding the firearm, and then he will collapse or something.

Anyway, the article has a strong bias that 'excited delirium' is a made-up term. Whatever the case, it seems like a term that police use as part of their jargon, and it means something useful and observation-oriented for them. The police won't be using a DSM-IV based term when they run across a man in a 7-11 who is wielding a firearm, disrobing, and drinking all of the gatorade. "Delirious" and "excited" both sound applicable to such individuals.

The tone of the article is so anti-establishment and biased I think it could use a major rewrite at best. Heathhunnicutt (talk) 07:38, 31 January 2010 (UTC)

Thank you for your suggestion. When you believe an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to). WhatamIdoing (talk) 01:36, 27 March 2010 (UTC)
It's a poor article, and it shows signs of biased editing from both sides.  Randall Bart   Talk  01:07, 16 February 2011 (UTC)

How much of the controversy has to stay in the intro? Right now virtually everything in the controversy section is also in the intro, which suggests undue weight and also looks messy. 101.171.170.151 (talk) 03:03, 24 March 2013 (UTC)

There are many dead links in the references of this article. An article like this needs better references.  Randall Bart   Talk  01:09, 16 February 2011 (UTC)


Don't delete other people's talk page discussion, Randall.

Excited delirium is a fake affliction that the Taser Corporation invented and pays doctors to testify about to describe why people shocked by tasers die of a condition entirely unrelated to the taser shortly after receiving that shock. I've never even heard of excited delerium being referenced outside of the United States and it's embarrassing that Wikipedia has to pretend it's something worthy of any respect in order to satisfy NPOV requirements.Torka1 (talk) 07:31, 29 May 2011 (UTC)

How exactly can a human have "superhuman strength"?

Isn't superhuman by definition more than a human could achieve? -98.84.129.253 (talk) 17:31, 2 February 2012 (UTC)

(S)he makes a good point. A very good point. That should be removed as it is literally a contradiction. Charles35 (talk) 07:47, 25 November 2012 (UTC)

The sources that are currently cited, use the name "superhuman strength" - other sources refer to this as "hysterical strength". I've linked the words in the article, to make that clearer.
We have an article on hysterical strength which is need of improvement (please help!), and some unrelated pages that include disambiguating information, such as superhuman strength. HTH. –Quiddity (talk) 21:33, 29 November 2012 (UTC)
I'd be glad to help. I don't think I'd be of much use with disambiguation pages though. That is out of my league. I checked out both articles. For the article "superhuman strength", the definition says that it is fictional strength exceeding that of a normal human, while nonfictional strength exceeding that of a normal human is hysterical strength. If that's the case, then why don't we just change superhuman strength in this article to hysterical? I've read that you are allowed to base edits off of other articles in place of sources.
On a different note, what exactly do you want to add to the hysterical strength page? I see the tag that says it needs sources, but sources on what? What type of material do you want to add?
On another unrelated note, I didn't get an answer from you on the medical info in the BCA page that we were discussing. Would you mind letting me know? Charles35 (talk) 23:31, 29 November 2012 (UTC)
The disputed nature of the syndrome, means we should be careful about changing words. One of the organizations that officially defines the condition, the American College of Emergency Physicians, uses the word "superhuman", so we probably should, too.
I'll reply to the other questions, at the relevant talkpages. –Quiddity (talk) 00:14, 30 November 2012 (UTC)
It is not a good idea to support a hypothetical syndrome with an improbable, unsupported phenomenon such as "hysterical strength." The use of the term "superhuman strength," as it was in the article, may still be the better choice, without the reference to "hysterical strength." In the context in which it originally appeared (the reference), it may have been used for convenience, or emphasis, and not as any type of accurate, scientific description of "excited delirium." For example, I think that Robert Dziekanski had been throwing heavy objects around during his rage in the Vancouver Airport. Although it would require considerable exertion, Mr. Dziekanski's actions were all still within the range of human strength, but certainly out of character for anyone behaving normally. The RCMP reports may have used terms like "superhuman strength," as anyone watching someone throw furniture around may well have described it the same way. The fact that Excited Delirium does not appear in the DSM-IV, or any similar manual, described in well-defined, verifiable, medical terms, does not mean that we have to supplant this by using pseudoscientific terms to do so. Rather than just heavy-handedly revert your edit, I would like to discuss this.
I'm afraid I can be of no assistance with the article on "hysterical strength," as I know of no evidence for it other than the anecdotal evidence that is already in the article. Unfortunately, actual empirical studies of hysterical strength would be completely unethical.StopYourBull (talk) 04:24, 30 November 2012 (UTC)
I know I'm late to this party, but from the looks of it, 'excited delirium' may be best thought of as an older term for a condition modern medicine calls by multiple different names--this happens every so often as medical knowledge improves. The white paper cited in the article would be useful here, but it's a dead link; my suspicion that the list would include the codes for Substance-induced_psychosis and this could accurately enough be used for when you've got somebody who seems to be high and psychotic but you somehow doubt they'll tell you what they took if you just asked nicely. Werhdnt (talk) 04:42, 24 December 2015 (UTC)

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Treatment ?

Needs a section on treatment - medical rather than Law Enforcement, preferably!--195.137.93.171 (talk) 08:57, 16 August 2016 (UTC)

Done. Doc James (talk · contribs · email) 23:01, 1 July 2017 (UTC)

Capture Myopathy

For more information on the subject research Capture Myopathy a simular condition which occurs in animals, specifically highly stressed wildlife when immobilized. — Preceding unsigned comment added by 75.154.96.31 (talk) 03:33, 27 November 2011 (UTC)

First sentence

"Excited delirium is a condition..." (my italics) seems too certain for what is a controversial and maybe speculative condition. I'm trying to think of an adjective to qualify it. "Excited delirium is a proposed condition..." or something like that (though we'd have to find a source proposing it).--94.193.231.87 (talk) 13:06, 31 January 2012 (UTC)

Core Issue

The article does not really address the core issue: if many (most?) cases of death from "Excited Delirium" occur in police custody, how can police procedures be modified so as to reduce the likelihood of death? In particular, it would seem logical that in those conditions (e.g. young male using certain adrenaline-enhancing drugs) the police should avoid procedures that seem to be associated with ED, and instead use medically-recommended procedures.Paulhummerman (talk) 12:45, 1 February 2012 (UTC)

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US- Specific?

The opening sentence says

"Excited delirium is a controversial term used to explain deaths of individuals in police custody"

I believe from reading the rest of the article that this is a US-specific article about a phenomenon happening locally. As usual an American author has assumed that all english speakers live in the USA. The article goes on to mention two things called "NPR" and "ABC" respectively, but does not link to anything else or attempt to clarify these TLAs.

Is there some way to clarify this? —Preceding unsigned comment added by 86.173.102.43 (talk) 19:29, 28 June 2010 (UTC)

Clarify what "ABC" or "NPR" means? "ABC" = "American Broadcasting Company", you know, just like "BBC" means "British Broadcasting Company" ...it's not that hard to figure out. By the way, if you search "ABC" guess what the first link is? Searching "NPR" actually takes you right to the article for National Public Radio. And what is with "USA" ? enough with the three letter acronyms already!! Lime in the Coconut 16:05, 7 July 2010 (UTC)
Almost half the examples and a good fraction of the rest of the article features purely Canadian sources. Canada is not part of the USA. WhatamIdoing (talk) 04:22, 8 July 2010 (UTC)
The Robert Dziekański Taser incident was in Canada! Excited delirium does it not exists. It was a euphemism for 'death by excessive police force'. → "Excited delirium entered into the public and media lexicon around the time that increased use of electrical weapons ignited controversy in the United States, Canada, and the UK. As a result, both medical task forces and public inquiries into the connection between police use of force, excited delirium, and in-custody deaths have recurred throughout the past decade." --217.234.71.31 (talk) 23:43, 4 July 2020 (UTC)

Diagnosis

The source says "The diagnosis does not specifically exist by name in the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) or in the 10th edition of the International Classification of Diseases (ICD-10) coding system. Both publications have other diagnoses which describe the population of patients exhibiting signs and symptoms of ExDS."[1]

This is a better summary of that IMO "The diagnosis does not go by this specific name in either the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases as of 2016."

It is not a psyc diagnosis so not expecting it to be in the DSM (try calling a psychiatrist about a case and they will direct you to the ER). The ICD10 is from 1992. Doc James (talk · contribs · email) 11:06, 14 October 2017 (UTC)

If it is not recognized, it is not recognized. That is why it is listed as a medical controversy. If it goes by a secret name that does have a code for a recognized medical diagnosis, then the article should be moved to the officially recognized name. I can also find articles by HIV deniers, so a few articles claiming it is recognized under a secret name are WP:Undue weight. --RAN (talk) 14:42, 14 October 2017 (UTC)
It is recognized within the field of emergency medicine. Yes it is newer than 1992 and yes it is not a psyc condition.
This 2012 review says "Based upon available evidence, it is the consensus of an American College of Emergency Physicians Task Force that Excited Delirium Syndrome is a real syndrome with uncertain, likely multiple, etiologies." [2]
Fairly clear. Doc James (talk · contribs · email) 16:14, 14 October 2017 (UTC)
Also, with the DSM, the general rule has been to only cover things that are persistent mental health problems, in part because of the stigma a psychiatric diagnosis can carry. If there's a good chance it may be a one-off episode and/or not actually a mental health problem, it probably won't be included, and it won't be included separately if it doesn't appear on its own as a persistent mental health problem. ICD-10's not quite designed to deal with uncertain etiologies if it might fall into different chapters. Werhdnt (talk) 22:53, 7 November 2018 (UTC)

"Hypothetical"

See #Diagnsos and https://onlinelibrary.wiley.com/doi/full/10.1111/acem.13330: "Our results suggest that excited delirium syndrome is a real clinical entity, that it still kills people, and that it probably has specific mechanisms and risk factors."

But we should note that "probably" leaves room for EXD being florid psychosis by another name.

Talpedia (talk) 17:49, 9 September 2020 (UTC)

Or that different people with similar symptoms should have different diagnoses. WhatamIdoing (talk) 02:06, 17 May 2021 (UTC)

Editing the Controversy Section

Hello! I am considering adding more to the controversy section to address the recent attention to Excited Delirium and police brutality. I have some potential sources on my user talk page. Let me know if you have any suggestions.MCJones20 (talk) 04:04, 11 September 2020 (UTC)

I added a quick mention of the use of ED to justify tranquilization, but that's kind of tangential and there is much more in the rest of the sources. Unfortunately I have noticed some nasty threatening vandalism, also some well referenced mentions of police involvement being removed, one of them removed part of a reference code and broke it so it seems they were not taking much care. So I'm a little concerned that the public controversy and politics may work it's way into the editing of this page. MasterTriangle12 (talk) 12:33, 28 September 2020 (UTC)

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