Delirium Tremens

(DTs)

Definition

Delirium tremens (DTs) is a severe disturbance of the brain caused by alcohol withdrawal.
Adult Brain
Brain Man Face
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
  • 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
  • Rapid breathing
  • Seizures
In severe cases, DTs can result in death, especially if untreated.

Diagnosis

You will be asked 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. Your bodily fluids may be tested. This can be done with blood tests. Your brain activity may be tested. This can be done with an Electroencephalogram (EEG). 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
  • Medications to control blood pressure and heart rate

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 such as Alcoholics Anonymous (AA).

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

Alcoholics Anonymous
http://www.alcoholics-anonymous.org

National Institute on Alcohol Abuse and Alcoholism
http://www.niaaa.nih.gov

CANADIAN RESOURCES

Alcoholics Anonymous
http://www.aacanada.com

Canadian Centre on Substance Abuse
http://www.ccsa.ca

References

Alcohol withdrawal. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 20, 2014. Accessed June 18, 2014.

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.

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