Cocaine-associated agitated delirium and the neuroleptic malignant syndrome

Wetli, Charles V.; Mash, Deborah C.; Karch, Steven B.

doi:10.1016/s0735-6757(96)90066-2

Cited by 143 publications

(65 citation statements)

References 12 publications

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“…Many victims of drug-induced excited delirium die without the application of any specific law-enforcement techniques. 14 Stone 113 noted that, on the basis of medical evidence, ECDs are not ''the causes, in and of themselves," of sudden deaths in custody. Some investigators have suggested that any description of ECD applications as ''the last straw" or ''being pushed over the edge," in cases of death during police confrontation, are simply ''unscientific emotional explanations."…”

Section: Discussionmentioning

confidence: 99%

“…Subjects who die after cocaine-associated excited delirium are often hyperthermic. 14 Karch,15 however, noted that hyperthermia might not be present in all cases. He hypothesized that the hyperthermia is due to an imbalance between dopamine D1 and D2 receptors and that, depending on the length of drug use and underlying disease, the receptors may not yet be out of balance.…”

Section: Lack Of Hyperthermia During Ecd Applicationsmentioning

confidence: 98%

“…Wetli et al 14 and Karch 15 have listed four components to be included in a definition of the excited delirium syndrome: delirium with agitation, respiratory arrest, hyperthermia, and death. One of the first uses of the specific term ''excited delirium" was by Wetli and Fishbain 16 (although ''cocaine-induced delirium" had been described before that time).…”

Section: Terminology and Definitions Of Excited Deliriummentioning

confidence: 99%

“…12,15,55 Hyperthermia Not associated in animal 33 or human studies. 64 Usually required for diagnosis; 14,15 often associated with cocaine. 14 …”

Section: Conflict Of Interestmentioning

confidence: 99%

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Deaths in custody: Are some due to electronic control devices (including TASER® devices) or excited delirium?

Jauchem

2010

Journal of Forensic and Legal Medicine

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a b s t r a c tDeaths have occurred after law-enforcement incidents involving applications of electronic control devices (ECDs) (including TASER Ò devices). An ''excited delirium" syndrome (reported in the literature prior to the development of ECDs currently in use), however, includes several factors that may be related to such deaths in custody. In this review, potential detrimental effects of ECDs are compared with possible changes due to excited delirium. Although extreme (i.e., long-duration or repeated) exposures to ECDs can result in significant hyperkalaemia, acidaemia, and myoglobinemia in animal models, limited applications (such as those normally used in law-enforcement situations) would appear to have only transient effects. In addition, the hyperthermia observed in patients with excited delirium does not seem to be directly exacerbated by ECD applications. ECD use is unlikely to be a common cause of ventricular fibrillation, but other events that are generally associated with excited delirium (e.g., drug use) may be related to subsequent ventricular fibrillation or asystole. Metabolic or respiratory acidosis may only be serious consequences of long-duration or repeated ECD applications. On the basis of current available information, factors other than ECDs themselves may be more important when death occurs after the use of ECDs.

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Section: Discussionmentioning

confidence: 99%

Section: Lack Of Hyperthermia During Ecd Applicationsmentioning

confidence: 98%

Section: Terminology and Definitions Of Excited Deliriummentioning

confidence: 99%

“…12,15,55 Hyperthermia Not associated in animal 33 or human studies. 64 Usually required for diagnosis; 14,15 often associated with cocaine. 14 …”

Section: Conflict Of Interestmentioning

confidence: 99%

See 2 more Smart Citations

Deaths in custody: Are some due to electronic control devices (including TASER® devices) or excited delirium?

Jauchem

2010

Journal of Forensic and Legal Medicine

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“…Aus der klinischen Beobachtung ist gut bekannt, dass Intoxikationen mit dopaminergen Substanzen, wie z.B. L-Dopa, Bupropion oder Kokain, delirante Zustände auslösen können [52,53]. Ebenfalls dürfte ein Dopaminüberschuss die Ursache für die Entwicklung deliranter Zustände im Rahmen einer hepatischen Enzephalopathie sein [54].…”

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