Endogenous Mental Disease Acute Psychotic Episodes

Excited delirium may also occur in the absence of stimulant drugs such as cocaine, methamphetamine or alcohol in individuals with endogenous mental disease. Clinically, these are usually referred to as acute psychotic episodes, and tend to occur in individuals with schizophrenia, schizoaffective disorders or delusional disorders. Acute psychotic episodes happen both in and out of mental facilities. They may occur because of the patient's discontinuance of medications or development of tolerance to the medications. If the episode occurs outside a mental health facility, the police are usually called on to deal with the individual; if inside the facility, it is nursing or support personnel. Sudden death can be caused by either the physiological effects of catechola-mine and hypokalemia following the struggle or a combination of these effects and the effects of the medications the patient is or was on. Many patients, nowadays, are on medications, some of which have a cardiotoxic potential. The tricyclic antidepressants, just like cocaine, block reuptake of norepinepnrine. The action of these drugs can predispose an individual to a cardiac arrhythmia.

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