Delirium acutum. Et vanskeligt behandleligt tilfælde i forløbet af en skizofreniform psykose

A case of delirium acutum in the course of a schizofrenic exacerbation is reported. A short review of the literature dealing with nosological and patophysiological aspects of delirium acutum is given. In this case the patient was treated with neuroleptics and diazepaminfusion for some days, but since his clinical condition rapidly deteriorated electrocovulsive therapy (ECT) was commenced, and after several treatments the patient finally improved. Possible mechanisms for the failure of diazepam in the treatment is discussed. It is concluded that ECT is the treatment of first choice in the case of threatening or fully developed delirium acutum.