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Behavioral Health Services/Psychiatry

Training Level

Resident PGY 1


Henry Ford Hospital


Delirious mania is a life-threatening syndrome characterized by rapid onset of delirium, mania, psychosis, and catatonia. It is crucial to include this in a differential as this condition responds poorly to traditional pharmacotherapeutic management of delirium or mania. Here, we present the case of a 71-year-old African American woman who was hospitalized with symptoms presenting as hyperactive delirium. She was found to have a UTI, which was treated, and she was discharged. However, due to the persistence of her psychiatric symptoms, she was brought back to the hospital. To target symptoms of hyperactive delirium, haloperidol was utilized as needed. However, the symptoms exacerbated and then included paranoia, psychomotor agitation, and eventually catatonia. Extensive medical workup was unrevealing. Eventually, benzodiazepines were utilized as monotherapy which led to gradual resolution of her symptoms. Although benzodiazepines are thought to exacerbate most cases of delirium, they are uniquely beneficial in cases of delirious mania.

Presentation Date


A case of suspected delirious mania treated with benzodiazepines