Sustained Manic Delirium

Abstract

Objective:

To report a case of bipolar I disorder with psychotic features that resembled a sustained episode of delirium.

Case Summary:

A 54-year-old white woman with bipolar I disorder developed severe, sustained psychosis resembling delirium. These symptoms resolved following several pharmacologic interventions.

Discussion:

Manic delirium is an extreme manifestation of bipolar disorder. The primary symptoms of manic delirium are confusion, agitation, altered levels of consciousness, and perceptual disturbances. Our patient developed typical symptoms of manic delirium; however, this case differed in terms of increased duration of symptoms and decreased treatment efficacy.

Conclusions:

Bipolar disorder with psychotic features may present as a delirious episode. Combination therapy may be an appropriate intervention when pharmacologic monotherapy fails.