Skip to main content

Delirious Mania: Recognition and Successful Treatment with Donepezil in the Context of Historical and Contemporary Investigations of Delirium and Delirious Mania | Chapter 02 | New Insights into Disease and Pathogen Research Vol. 1

Aims: Presentation of a case of severe delirious mania with resolution of delirium after treatment with donepezil.

Presentation of Case: KA was a 44 y/o Australian female with a history of bipolar affective disorder with psychotic manic episodes. Two weeks prior to her psychiatric admission she was admitted to a medical ward after an overdose (OD) of acetaminophen. On review, it appeared that this OD may have been the beginning of an unrecognized delirious mania. The patient was sent home and returned 2 weeks later for a prolonged psychiatric admission with multiple medical comorbidities. Psychiatric management and medical care were provided in intensive settings and despite adequate treatment and improvement in mood symptoms, her delirium did not resolve. Immediately upon institution of donepezil, her delirium resolved. After a period of stability, donepezil was stopped. Her delirium returned and donepezil was reinstituted with resolution of normal cognitive function.

Discussion: The DSM 5 criteria for Delirium and some inherent difficulties using these criteria are discussed. A review of the literature of delirious mania is presented which shows unresolved controversies but an evolving recognition of this disorder. A Cochrane Review shows no benefit in the use of acetylcholinesterases in the treatment of delirium. However, the multiple etiologies and pathological processes involved in delirium may require unique and individual recognition and management.

Conclusion: This case suggests that the use of donepezil is strongly recommended in the treatment of delirious mania.  Further study is required to clarify in this challenging disorder.

Author(s) Details

Dr. Laurie Jo Moore
Cairns Base Hospital, Mental Health Unit, Cairns, Queensland, Australia.

Dr. Mila Goldner-Vukov
Cairns Base Hospital, Mental Health Unit, Cairns, Queensland, Australia.

Comments

Popular posts from this blog

A Brief Study of Middleware Technologies: Programming Applications and Management Systems | Chapter 15 | Novel Research Aspects in Mathematical and Computer Science Vol. 1

  Many platforms, services, applications, hardware, and operating systems are connected through the middleware layer. Because the middleware layer abstracts much low-level complexity and makes applications and software systems portable, it allows disparate systems to interface and function together in harmony. Middleware technologies enable software engineers to swiftly construct software systems and applications, allowing developers to focus on more important tasks. This chapter examines several types of middleware systems and discusses middleware capabilities, middleware operation, middleware's function in cloud-based systems, and the best middleware platforms to use. Middleware systems are widely utilised and can be found in practically any software system or application. Middleware programmes provide as a link between many sorts of systems and protocols. They serve as a mechanism for various systems. To successfully exchange information, it runs on a variety of operating system

A Prospective Study about Safety and Efficacy of Perioperative Lidocaine Infusion | Chapter 09 | New Horizons in Medicine and Medical Research Vol. 8

 Opioids cause clinically significant side effects such as respiratory depression, immunosuppression, muscle rigidity, negative inotropism, nausea, vomiting, hyperalgesia, urine retention, postoperative ileus, and drowsiness. Perioperative opioids are a major contributor to the United States' and other countries' opioid epidemics. Non-opioid analgesics, particularly lidocaine, are becoming more common for perioperative use as a result of this. A total of 185 adult patients were randomly assigned to one of two groups: control group I (105 patients) [fentanyl group] or group ii (80 patients) [opioid-free anaesthesia group]. Lidocaine 1.5 mg/kg bolus followed by 1.5 mg/kg/h infusion intraoperatively, and 1.5-2 mg/kg/h infusion for 2-8 hours postoperatively were given to patients in both groups at anaesthetic induction. Intraoperatively, both groups received analgesic adjuvants such as diclofenac 75 mg, paracetamol 1 gm, and mgso4 30-50 mg/kg. If the mean arterial pressure (map)

A Case Report on Delayed Diagnosis of Glioblastoma | Chapter 07 | New Horizons in Medicine and Medical Research Vol. 8

  The clinical and radiological indications of a concomitant tumour may be hidden by the rupture of a cerebral aneurysm. The goal of this study is to raise awareness about the dangers of delayed diagnosis by recounting the case of a patient who had a subarachnoid haemorrhage that hid the presence of a glioblastoma for several months. Only a few similar cases have been recorded in the literature: The therapy of two recent severe neurosurgical illnesses is discussed in this article. Author(S) Details Gabriele Ronchetti Department of Neurosurgery, Ospedale San Giovanni Bosco, ASL Cittá di Torino, Italy. Carlo Giussani Department of Surgery and Translational Medicine, San Gerardo Hospital, University of Milano Bicocca, via Pergolesi 33, 20900, Monza, Italy. View Book:- https://stm.bookpi.org/NHMMR-V8/article/view/6645