Delirium tremens

What Are Delirium Tremens?

Delirium tremens is a severe form of alcohol withdrawal. Delirium tremens (DTs) typically occur in people who have been heavily drinking alcohol for several months or more. People who have been drinking for a period for more than 10 years can also experience delirium tremens when they attempt to quit drinking. Delirium tremens can also be experienced by individuals withdrawing from benzodiazepines.

Causes

Delirium tremens are typically experienced by individuals with a history of severe alcohol abuse. Once a person has become dependent on alcohol and they use it every day over a long period of time, the body requires it to function normally. When a person abruptly stops using alcohol, their body can no longer adapt without alcohol. People with severe forms of alcohol addiction can experience delirium tremens. Benzodiazepine addiction can cause a similar reaction.

Who Is at Risk for Delirium Tremens?

All long-term, heavy drinkers are at risk for delirium tremens when they stop drinking. Heavy drinking is defined by 8 drinks a week for women and 15 drinks a week for men. Binge drinking is considered the most common form of heavy drinking, and is defined by 4 or more drinks in one setting for women and 5 or more for men.

Aside from extended periods of heavy drinking, additional risk factors for delirium tremens include:

  • A history of experiencing alcohol withdrawal symptoms
  • Drinking heavily for extended periods of time (several months to several years)
  • Additional health problems aside from alcohol addiction
  • Suffering prior brain damage
  • A history of experiencing seizures

Symptoms

Symptoms of delirium tremens will typically occur 48-96 hours after a person has had their last drink. They can also take as long as 7-10 days to occur in some individuals. Delirium tremens can be life threatening and is considered a medical emergency. Common symptoms of delirium tremens include:

  • Severe confusion
  • Sudden changes in mood/emotions
  • Excitement
  • Restlessness
  • Anxiety
  • Depression
  • Fear
  • Irritability
  • Nausea
  • Vomiting
  • Sweating
  • Hallucinations
  • Increased heart rate
  • Stomach pain
  • Seizures

Treatment for Delirium Tremens

Anyone with a history of serious alcohol abuse over a long period of time needs to get professional help through the detox process. During a medically-assisted detox, qualified medical professionals will look for certain signs and run a series of tests. Signs of delirium tremens a doctor will look for include:

  • Irregular heart rate
  • Hand tremors/shaking
  • Fever
  • Dehydration

Tests that can assess the severity of a person’s withdrawal symptoms include:

  • Blood magnesium level
  • Blood phosphate level
  • Toxicology screen
  • Comprehensive metabolic panel
  • Electrocardiogram (ECG)
  • Electroencephalogram (EEG)

Treatment for delirium tremens requires staying at the hospital or a professional detox facility. Patients will be monitored and bodily fluid levels, vital signs, and blood chemistry will be regularly checked to ensure the individual’s safety.

Medications such as benzodiazepines are administered to relieve discomfort of withdrawal symptoms, keep a person sedated and calm through detox, and treat any seizures or tremors that occur.

The goal of receiving treatment for delirium tremens is to help manage withdrawal symptoms, prevent any medical complications that may arise, and to prevent heart failure or death.

Delirium Tremens FAQ

How long do delirium tremens last?

The length of time a person experiences delirium tremens is dependent upon the extent of their addiction. Time is typically based on how much a person drinks and for how long they’ve been drinking. Some people will experience delirium tremens for up to 24 hours, while others will have symptoms that last for up to a week or longer.

Is delirium tremens life-threatening?

Yes. A person with a severe alcohol addiction runs can face life-threatening medical circumstances when they abruptly quit drinking. Delirium tremens is fatal in approximately 5-15 percent of patients who experience them.

How does medication help with delirium tremens?

Benzodiazepines such as Valium or Librium are often used to treat delirium tremens. They work to sedate the patient and supress any excitability experienced by the central nervous system. These medications also help a person to remain calm during the trying symptoms of detoxification.

External Links

Delirium tremens, Medline Plus

Alcohol Withdrawal Delirium, Rose Kivi, Elizabeth Boskey, PhD, and Ana Gotter, Heathline, 2017

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