Lurasidone-Induced Delirious Mania

Yeo, Li-Xian; Kuo, Ting-Chun; Hu, Khai-Chi; Lim, Zhu-Wei; Yeh, Ta‐Chuan; Tzeng, Nian‐Sheng

doi:10.1097/mjt.0000000000000959

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…However, in the case of lurasidone, case reports indicate that there is risk at all dosages and that lowering the blood levels is the only way to reduce risk. 18,27,28 Quetiapine may be the safer of the two.…”

Section: Related Literaturementioning

confidence: 99%

Informed Consent: Do atypical antipsychotics trigger manic switching in patients with bipolar I disorder?

Stevenson

2020

Clin. Res. Pract.

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A 22-year-old newly diagnosed patient with bipolar is discussing with her doctor the safety of starting an atypical antipsychotic as part of her treatment plan for depression. The patient was recently diagnosed with bipolar disorder after years of ups and downs making school and her relationship especially difficult. After seeking out a university student health psychiatrist for a severe depressive episode she was prescribed an antidepressant, which within a few weeks triggered a manic episode that required hospitalization. Since that time she has been compliant with her medications but has fallen into another depressive episode. Her psychiatrist encourages her to begin taking the atypical antipsychotic quetiapine because it may help with her current mood. Given her experience with antidepressants she is apprehensive. She asks, is it possible that a medication like quetiapine could trigger another manic episode?

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Section: Related Literaturementioning

confidence: 99%

Informed Consent: Do atypical antipsychotics trigger manic switching in patients with bipolar I disorder?

Stevenson

2020

Clin. Res. Pract.

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“…15 17 Others have taken a broader view of delirious mania and included cases that appear secondary to medical disorders and medication. [18][19][20] The syndrome has an acute onset and autonomic instability and hyperpyrexia occur in some but not all cases. 12 We report a case of delirious mania associated with otherwise mild COVID-19 pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Delirious mania in a patient with COVID-19 pneumonia

et al. 2021

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Delirious mania (the coexistence of delirium and mania) is described in the literature but not recognised in standard nosologies. We report a woman in her late 30s, with no psychiatric history, who presented with concurrent symptoms of mania and delirium. She was diagnosed with COVID-19 pneumonia (positive reverse transcription-PCR test). There was no history of substance misuse or concurrent medical illness. CT head scan was normal as were blood investigations, other than elevated inflammatory markers. She received standard treatment for COVID-19 pneumonia and lorazepam and quetiapine to treat her neuropsychiatric symptoms. She made a full recovery after 9 days. She was apyrexial with normal oxygen saturation throughout her illness. The case shows that severe neuropsychiatric symptoms can complicate otherwise mild COVID-19 pneumonia with neuroinflammation being a possible mechanism. A diagnosis of delirious mania appears to better capture the complexity of the presentation than a diagnosis of mania or delirium alone.

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“…For example, some cases that have been reported as delirious mania had more evidence of primary delirium due to another medical condition or primary mania. 12,13 Other cases have demonstrated swift improvement of symptoms after monotherapy with antipsychotics without a trial of benzodiazepines or electroconvulsive therapy (ECT); the exclusion of a sudden onset questions the validity of the diagnosis and promotes the use of less efficacious treatments. 14,15 Other reports have confirmed that the diagnosis is missed when certain symptoms are more predominant, such as a thought disorder (acute schizophrenia), grandiosity and delusional ideation (bipolar disorder [BD]), and less commonly assessed catatonic signs (ambitendency, automatic obedience).…”

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confidence: 99%

Delirious mania: Presentation, pathogenesis, and management

Reinfeld

2023

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D elirious mania is a syndrome characterized by the acute onset of severe hyperactivity, psychosis, catatonia, and intermittent confusion. While there have been growing reports of this phenomenon over the last 2 decades, it remains poorly recognized and understood. 1,2 There is no widely accepted nosology for delirious mania and the condition is absent from DSM-5, which magnifies the difficulties in making a timely diagnosis and initiating appropriate treatment. Delayed diagnosis and treatment may result in a detrimental outcome. 2,3 Delirious mania has also been labeled as lethal catatonia, specific febrile delirium, hyperactive or exhaustive mania, and Bell's mania. 2,4,5 The characterization and diagnosis of this condition have a long and inconsistent history (Box, 1,6-11 page 28).Delirious mania continues to be met with incertitude in clinical practice, and numerous inconsistencies have been reported in the literature. For example, some cases that have been reported as delirious mania had more evidence of primary delirium due to another medical condition or primary mania. 12,13 Other cases have demonstrated swift improvement of symptoms after monotherapy with antipsychotics without a trial of benzodiazepines or electroconvulsive therapy (ECT); the exclusion of a sudden onset questions the validity of the diagnosis and promotes the use of less efficacious treatments. 14,15 Other reports have confirmed that the diagnosis is missed when certain symptoms are more predominant, such as a thought disorder (acute schizophrenia), grandiosity and delusional ideation (bipolar disorder [BD]), and less commonly assessed catatonic signs (ambitendency, automatic obedience). These symptoms are mistakenly attributed to the respective

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Lurasidone-Induced Delirious Mania

Cited by 4 publications

References 7 publications

Informed Consent: Do atypical antipsychotics trigger manic switching in patients with bipolar I disorder?

Informed Consent: Do atypical antipsychotics trigger manic switching in patients with bipolar I disorder?

Delirious mania in a patient with COVID-19 pneumonia

Delirious mania: Presentation, pathogenesis, and management

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