Department of Psychiatric Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA.
Gen Hosp Psychiatry. 2012 Nov-Dec;34(6):647-50. doi: 10.1016/j.genhosppsych.2012.06.005. Epub 2012 Aug 13.
Synthetic analogs of the cathinone molecule have seen increasing recreational use as substitutes for cocaine, 3,4-methylenedioxymethamphetamine (ecstasy) and methamphetamine. Repeated use of these drugs is associated with a paranoid hallucinatory delirium. A subset of patients using these substances develops a syndrome of extreme agitation and violent behavior that has been reported following the use of other stimulant drugs that also produce rapid changes in brain monoamines. This syndrome, characterized as "excited delirium," presents to the acute care setting with a challenging combination of paranoia, severe agitation and violent behavior. These patients frequently suffer from dehydration, skeletal muscle damage and renal failure that may lead to multiorgan failure and death. Management of these individuals requires careful consideration of the consequences of interventions commonly implemented in medical settings to control dangerous aggressive behavior.
该类化合物被作为可卡因、摇头丸（3,4-亚甲二氧基甲基苯丙胺）和冰毒的替代品，在娱乐场所中被越来越多地滥用。反复使用这些药物会导致出现偏执性幻觉谵妄。有一小部分使用这些物质的患者会出现极度兴奋和暴力行为的综合征，在使用其他同样会快速改变脑单胺类物质的兴奋剂药物后也有报道。这种综合征被称为“兴奋性谵妄”，在急性护理环境中出现，表现为偏执、严重兴奋和暴力行为的混合。这些患者经常出现脱水、骨骼肌损伤和肾衰竭，可能导致多器官衰竭和死亡。管理这些患者需要仔细考虑医疗环境中实施的干预措施的后果，以控制危险的攻击性行为。
