Excited delirium is a brain disorder.
This disorder is usually drug-related (cocaine or "crack", PCP or "angel dust", methamphetamine, amphetamine), but can occur in non-drug users as well.
The presentation of excited delirium occurs with a sudden onset, with symptoms of bizarre and/or aggressive behavior, shouting, paranoia, panic, violence toward others, unexpected physical strength, and hyperthermia. Hyperthermia is a harbinger of death in these cases.
Neurochemical systems in the brain are abnormal in this disorder. At the molecular level, excited delirium is characterized by dysregulated dopamine transporters (hyperdopaminergic state), elevated heat shock proteins (hyperthermia), and immediate early gene activation as a marker of paranoid aggression (c-fos protein). These molecular changes serve as biomarkers of the disorder.
While many factors are associated with sudden death in individuals requiring restraint for excited delirium, these individuals develop a disturbance in thought, behavior and mood, and become agitated and violent. This abnormal behavioral state is due to CNS mechanisms which are the cause of lethality. The brain controls the heart and respiration. Abnormal brain activity leads to the psychosis and sudden death
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Had a transcendental storm of colour visions today in the bus going to Marseilles. We ran though a long avenue of trees and I close my eyes against the setting sun. An overwhelming flood of intensely bright colours exploded behind my eyelids: a multi-dimensional kaleidoscope whirling out through space. I was swept out of time. I was out in a world of infinite number. The vision stopped abruptly as we left the trees. Was that a vision? What happened to me?
Brion Gysin, diary entry, 1958
excerpt from On Acid: A Field Guide to Altered States (p. 50-51)
Coroner: Painter Thomas Kinkade died from an accidental overdose of alcohol and prescription tranquilizers.