Excited Delirium Syndrome

The term "excited delirium" (ExDS) was first used in a 1985 Journal of Forensic Sciences article, co-authored by deputy chief medical examiner for Dade County, Florida. Charles Victor Wetli (1943—2020), entitled Cocaine-induced psychosis and sudden death in recreational cocaine users. The JFS article reported that in "five of the seven" cases they studied, deaths occurred while in police custody. Wetli determined that nineteen women, all Black prostitutes, had died of the condition due to "sexual excitement" while under the influence of cocaine. In 1992, police announced they had found a serial killer responsible for deaths determined by Wetli to be excited delirium. The legitimacy of the condition has since been under controversy with most of the medical community not recognizing it, and there is no official entry for it in the official Diagnostic and Statistical Manual of Medical Disorders.

The supposed risk factors vary including "bizarre behavior generating phone calls to police", "failure to respond to police presence", and "continued struggle despite restraint". It supposedly endows individuals with "superhuman strength" and being "impervious to pain." 

In 1849, a superficially similar condition was described by Luther Bell as "Bell's mania". Bell was one of thirteen other mental hospital superintendents who met in Philadelphia in 1844 to organize the Association of Medical Superintendents of American Institutions for the Insane (AMSAII), now the American Psychiatric Association.

Excited delirium (ExDS), also known as agitated delirium (AgDS), is a controversial diagnosis sometimes characterized as a potentially fatal state of extreme agitation and delirium. It is typically diagnosed postmortem in young adult males, disproportionally Black men, who were physically restrained at the time of death, most often by law enforcement personnel. Symptoms are said to include aggressive behavior, extreme physical strength and hyperthermia.

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