Acute exhaustive mania and sudden death presents with behavioral symptoms that are identical to what is described for ExDS in psychostimulant abusers. Bell's mania or acute exhaustive mania was first described in the 1850's by American psychiatrist Luther Bell in institutionalized psychiatric patients. This rare disorder of violent mania, elevated body temperature and autonomic collapse continued to be described by others in the psychiatric literature, but with different names until the first cases of ExDS were seen at the beginning of the cocaine epidemic by medical examiners

Delirious mania is a neuropsychiatric condition characterized by the rapid onset of delirium, psychosis, and mania.

Delirious Mania (Stage III).

This stage can also involve a combination of mania and psychosis. Because delirious mania can be profoundly disorienting, many people experiencing it need to be hospitalized to prevent injury to themselves or others.