Delirium Tremens
En Español (Spanish Version)

Definition
Delirium tremens (DTs) is a severe disturbance of the brain caused by alcohol withdrawal.

Adult Brain

The sudden withdrawal or decrease of alcohol can cause severe disturbances in the brain.
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Causes
DTs occur when a person who repeatedly drinks large amounts of alcohol suddenly stops or decreases the amount of alcohol consumed.

Risk Factors
These factors increase your chance of developing DTs:

  • History of heavy alcohol use and abuse
  • History of DTs or other withdrawal symptoms
  • Other medical problems in addition to alcohol abuse
Symptoms
Symptoms usually begin 3-7 days after suddenly stopping or decreasing alcohol intake. Symptoms may include:

  • Anxiety
  • Confusion and disorientation
  • Delirium—changing levels of alertness
  • Trouble sleeping
  • Bad dreams
  • Severe agitation
  • Fever
  • Hallucinations—the perception of a thing, voice, or person that is not present, both visual and auditory
  • Delusions—a false belief that is strongly held
  • Tremors of the hands, head, or body
  • Severe sweating
  • Rapid heartbeat
  • Nausea
  • Increased rate of breathing
  • Increased blood pressure
  • Increased body temperature
  • Seizures
In severe cases, DTs can result in death, especially if untreated.

Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done. The diagnosis of DTs is usually based on the symptoms and signs of the disorder after stopping alcohol use. Tests may include:

  • Blood tests to measure liver function, blood clotting ability, or electrolyte levels.
  • Electroencephalogram (EEG) to measure electrical activity in your brain.
  • Images of your internal body structures can be taken with:
Treatment
Treatment can be difficult. Clearing of DTs may begin in 12-24 hours, but may take up to 2-10 days. Treatment for alcohol abuse is necessary after DTs are under control.

Talk with your doctor about the best treatment plan for you. Options may include:

Medication
Medications may include:

  • Sedatives
  • Anticonvulsants
  • Other antiseizure medication
Vitamins and Fluids
Severe, life-threatening vitamin deficiency or dehydration may accompany DTs. Treatment may include:

Rehabilitation
Treatment for alcohol abuse may be done in a hospital setting or while living at home. It may involve individual or group therapy. Many people seek support by participating in groups, like Alcoholics Anonymous (AA).

If you are diagnosed as experiencing DTs, follow your doctor's instructions.

Prevention
To prevent having DTs, do not abuse alcohol. If you do drink large amounts on a regular basis, do not suddenly decrease the amount or stop drinking on your own. Rather, get advice from your doctor on the safest way to lower your intake.




RESOURCES:

National Institute on Alcohol Abuse and Alcoholism

CANADIAN RESOURCES:
Alcoholics Anonymous

Canadian Centre on Substance Abuse

References:
Alcohol withdrawal. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 4, 2013. Accessed July 11, 2013.

Barrons R, Roberts N. The role of carbamazepine and oxcarbazepine in alcohol withdrawal syndrome. J Clin Pharm Ther. 2010;35(2):153-167.

Bayard M, McIntyre J, et al. Alcohol withdrawal syndrome. Am Fam Physician. 2004;69(6):1443-1450.

McKeon A, Frye MA, et al. The alcohol withdrawal syndrome. J Neurol Neurosurg Psych. 2008;79:854-862.

Last Reviewed July 2013



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