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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