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Archive 1 |
"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):
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)
(peripherial manifestations)
2. Comatose form:
(central manifestations)
(peripherial manifestations)
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)
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
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 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.
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)
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)
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.
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)
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)
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 :)
DumZiBoT ( talk) 18:46, 12 August 2008 (UTC)
Done WhatamIdoing ( talk) 04:48, 3 September 2008 (UTC)
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)
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)
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)
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.
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)
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)
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)
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)
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Needs a section on treatment - medical rather than Law Enforcement, preferably!-- 195.137.93.171 ( talk) 08:57, 16 August 2016 (UTC)
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)
"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)
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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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)
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)
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)
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)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 |
"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):
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)
(peripherial manifestations)
2. Comatose form:
(central manifestations)
(peripherial manifestations)
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)
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
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 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.
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)
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)
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.
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)
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)
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 :)
DumZiBoT ( talk) 18:46, 12 August 2008 (UTC)
Done WhatamIdoing ( talk) 04:48, 3 September 2008 (UTC)
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)
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)
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)
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.
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)
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)
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)
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)
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Needs a section on treatment - medical rather than Law Enforcement, preferably!-- 195.137.93.171 ( talk) 08:57, 16 August 2016 (UTC)
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)
"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)
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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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)
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)
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)
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)