Definition

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

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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 DTs
  • Other medical problems in addition to alcohol abuse
  • Brain damage
  • Age: Older than 30 years

    • Symptoms

    Symptoms usually begin 2-4 days after suddenly stopping or decreasing alcohol intake. Symptoms may include:

        
  • Anxiety
  • Confusion / 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. Tests may include:

        
  • You may have your bodily fluid tested. This can be done with blood tests to measure liver function, blood clotting ability, or electrolytes.
  • You may need to have your brain function evaluated. This can be done with electroencephalogram (EEG).
  • You may need to have pictures taken of your bodily structures. This can be done with:     
  • CT scan
  • MRI scan

    • Treatment

    Treatment can be difficult. DTs are likely to last for 5-7 days. 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.

    Treatment may include:

    Medication

    Medicines may include:

        
  • Sedatives to:     
  • Calm agitation
  • Ease withdrawal symptoms
  • Aspirin or acetaminophen to lower fever
  • Anti-seizure medicine

    • Vitamins and Fluids

    Severe, life-threatening vitamin deficiency or dehydration may accompany DTs. Treatment may include:

        
  • IV fluids, magnesium , and glucose
  • IV doses of vitamin C and B-complex vitamins, including thiamin and folic acid

    • 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.