Treating Manic Stupor

The unusual feature of this case was the development of manic stupor. Although this condition is described in classical texts (e.g. Hamilton. 1974). in clinical practice most psychiatrists never see a case in their lifetime. It is seldom easy to make the diagnosis prospectively Usually, several differential diagnoses are entertained, including neuroleptic malignant syndrome, for such patients have often received neuroleptic drugs. The stupor ultimately resolves e-ther spontaneously or with the help of antipsychotic drugs, benzodiazepines, or ECT, and the diagnosis of manic stupor is restrospectively made once the stupor remits and the manic symptoms are uncovered. Descriptions of manic stupor are very rare, the most recent being those by Fink (1999); none have appeared in Indian literature. What is notable about the present case is that the stupor was prolonged (it lasted more than two days), and a theme of ecstasy, rather than delirious behaviour, predominated.