A Case of Delirious Mania Treated with Electroconvulsive Therapy

Life · 5 authors, 5 centres

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TL;DR

The initial BFCRS score was 36, indicating severe symptomatology.

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The initial BFCRS score was 36, indicating severe symptomatology. Intravenous benzodiazepines produced partial improvement, while mood stabilizers and antipsychotics were ineffective. After the sixth ECT application, motor symptoms improved with recovery of voluntary movements, walking, facial expression, and oral feeding. After eleven ECT applications, confusion and disorientation resolved, and the patient was alert and oriented at discharge with a BFCRS score of 3. This is a single case report with no control group, and it was not possible to verify whether the patient experienced hallucinations or delusions during hospitalization.

STUDY TYPE

case_report

SPECIALTY

psychiatry

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100% · A

ORIGINAL PAPER

PMC10381179

A Case of Delirious Mania Treated with Electroconvulsive Therapy

Life

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ABSTRACT

Abstract (1) Background: Delirious mania is a neuropsychiatric condition characterized by the rapid onset of delirium, psychosis, and mania. Due to the presence of catatonic signs and symptoms, some authors considered this syndrome to be a specific excited catatonia subtype. Usually, delirious mania is responsive to intravenous benzodiazepines (BZDs) or to electroconvulsive therapy (ECT). (2) Methods: In the present study, we describe the case of a 64-year-old woman with a diagnosis of recurrent major depressive disorder. We assessed the severity of the clinical picture and the response to ECT treatment with the Bush–Francis Catatonia Rating Scale (BFCRS). (3) Results: After eleven sessions of ECT, the patient presented a reduced BFCRS total score, with a resolution of the autonomic abnormalities (temperature, respiratory, and heart rate). (4) Conclusions: These data demonstrate how important it is to diagnose this syndrome as soon as possible to set up an effective therapy, avoiding the use of antipsychotic drugs and preventing potentially fatal complications. The initial administration of BZDs IV and the subsequent ECT application, associated with intensive care of life-threatening general medical conditions, guaranteed us a good level of efficacy in obtaining a complete resolution of the clinical picture. Keywords: delirious mania, electroconvulsive therapy, bipolar disorder, somatic treatment, catatonia

CITATION EXPORT

Beniamino Tripodi, Manuel Glauco Carbone, Irene Matarese et al.. A Case of Delirious Mania Treated with Electroconvulsive Therapy. Life. (2023). https://doi.org/10.3390/life13071544

AUTHORS

5 · 5 CENTRES

Beniamino Tripodi, Manuel Glauco Carbone, Irene Matarese, Lorenzo Lattanzi, Pierpaolo Medda

1Department of Mental Health and Addictions, Division of Psychiatry, ASST Crema, Via Largo Ugo Dossena 2, 26013 Crema, CR, Italy
2Pisa-School of Experimental and Clinical Psychiatry, University of Pisa, Via Roma 57, 56100 Pisa, PI, Italy
3Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100 Varese, VA, Italy
4Department of Surgical, Medical, Molecular and Critical Area Pathology, Clinical and Health Psychology, University of Pisa, Via Roma 57, 56100 Pisa, PI, Italy
5Department of Experimental and Clinic Medicine, Section of Psychiatry, University of Pisa, Via Roma 57, 56100 Pisa, PI, Italy