This is a medical emergency. For this reason, Dr. Bisaga says health professionals should recognize excited delirium as a medical issue that requires urgent care, rather than as a behavioral issue with no need for immediate intervention—which could lead to serious complications or even death. Dopamine is a neurotransmitter, a chemical messenger that influences behavior and physical body functions.
One explanation for an uptick in dopamine levels is drug use, specifically cocaine. Excited delirium is also linked to a history of schizophrenia and bipolar disorder , he adds. Whatever the exact cause, the sharp increase in dopamine levels can be life-threatening. First, doctors will attempt to verbally calm the patient. If that doesn't work, they'll typically use physical restraint like wrist and ankle-locking.
If the patient is violent and not yet at a hospital, they may be sedated on site by EMS workers, or the sedation could occur in the ER. The first-line sedative is usually Versed or Ativan—followed by ketamine, if those don't appear to work. Then use a quote, if necessary, to announce the importance of the distinction.
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