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Delirium Tremens

Last updated May 21, 2018

Approved by: Maulik P. Purohit MD, MPH

Delirium Tremens (DTs) is potentially an emergency medical condition. The condition mainly occurs when heavy alcohol consumption over a long period of time is suddenly stopped.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Alcohol Withdrawal - Delirium Tremens
  • Alcohol Withdrawal Delirium
  • DTs (Delirium Tremens)

What is Delirium Tremens? (Definition/Background Information)

  • Delirium Tremens (DTs) is potentially an emergency medical condition. The condition mainly occurs when heavy alcohol consumption over a long period of time is suddenly stopped
  • Individuals with a history of alcohol consumption for prolonged periods (over 10 years) have a high risk for DTs. This condition is also referred to as Alcohol Withdrawal Delirium
  • The signs and symptoms of Delirium Tremens may be indicative of both the physical and mental health of the affected individual. The signs and symptoms include body tremors, loss of appetite, palpitations, disorientation, anxiety, and depression
  • The complications of Delirium Tremens may include seizures, mental or physical self-injury; DTs can even result in death
  • Delirium Tremens is treated with medication and by maintaining homeostatic body levels (restoring body equilibrium). The prognosis may be guarded or unpredictable despite appropriate treatment, since Delirium Tremens can be a life-threatening condition
  • Delirium Tremens can be prevented by altogether eliminating alcohol consumption and having suitable counseling and therapy sessions, including group therapy

Who gets Delirium Tremens? (Age and Sex Distribution)

  • Delirium Tremens is generally seen in adults
  • The condition can affect both males and females
  • All races and ethnicities can develop DTs and no specific preference is observed

What are the Risk Factors for Delirium Tremens? (Predisposing Factors)

The risk factors for Delirium Tremens may include the following:

  • A history of heavy consumption of alcohol; individuals who have abused alcohol for more than 10 years have a high risk
  • Individuals who consume the following or more measures of alcohol including 4 to 5 pints of wine, 7 to 8 beers, or 1 pint of “hard” alcohol, every day for a long period of time

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Delirium Tremens? (Etiology)

Delirium Tremens can be caused by ceasing alcohol intake after having consumed alcohol for prolonged period of time (usually several years).

  • The condition develops faster, if drinking of alcohol occurs with low food consumption
  • Delirium Tremens can also be caused by head injury, infection, or illness in combination with a history of heavy alcohol consumption

What are the Signs and Symptoms of Delirium Tremens?

The signs and symptoms of Delirium Tremens commonly develop 48 to 96 hours (2-4 days) after heavy drinking is stopped. Sometimes, it may take 7-10 days for onset of the symptoms following stoppage of alcohol intake. The signs and symptoms of Delirium Tremens may include:

  • Body tremors
  • Fatigue
  • Alteration in mental ability that includes:
    • Agitation, irritability
    • Confusion
    • Disorientation
    • Decreased attention span
    • Delirium
    • Hallucinations
  • Deep sleep for a day or longer
  • Stupor
  • Excitement or restlessness
  • Fear
  • Increased activity
  • Mood changes
  • Sensitive to light, sounds, and touch
  • Seizures or convulsions (generalized tonic-clonic): The type of convulsion seen is generalized tonic-clonic
    • Usually seen 12 to 48 hours after drinking has stopped
    • Usually seen in individuals with a history of alcohol withdrawal
  • Alcohol withdrawal symptoms that include:
    • Anxiety, depression
    • Headache
    • Insomnia
    • Irritable or excitable
    • Lowered appetite
    • Nausea and vomiting
    • Nervousness or being jumpy
    • Pale skin
    • Palpitations
    • High changes in emotion
    • Shakiness
    • Sweatiness of palms and face
  • Generalized symptoms such as:
    • Chest pain
    • Fever
    • Stomach pain

How is Delirium Tremens Diagnosed?

  • Delirium Tremens can be diagnosed with a physical exam by a healthcare professional by considering the following signs:
    • Sweating
    • Increased startle reflex: It is an abnormal startle response that occurs to a stimulus. For example - the sudden clapping of hands will result in an exaggerated startle response in an individual with Delirium Tremens
    • Irregular heartbeat
    • Eye muscle movement problems
    • Rapid heart rate and rapid muscles tremors
  • Other tests can be used to diagnose Delirium Tremens such as:
    • Blood magnesium and phosphate levels
    • Comprehensive metabolic panel
    • Electrocardiogram (ECG)
    • Electroencephalogram (EEG)
    • Toxicology screen test

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Delirium Tremens?

Possible complications of Delirium Tremens are as follows:

  • Seizures or convulsions
  • Mental or physical injury from seizures
  • Self-injury or injury to others due to altered mental state
  • Fatal arrhythmias: Irregular heartbeat that can be fatal

How is Delirium Tremens Treated?

The treatment goal for Delirium Tremens is to save the individual’s life, decrease symptoms, and prevent complications that may occur due to the condition. The healthcare professional may undertake the following treatment measures:

  • Treating electrolyte/fluid imbalance, stabilization of vital signs/organs including blood pressure and heart rate
  • The treatment will involve medication to keep the individual relaxed, treat seizures, anxiety, tremors, or mental disorders
  • Treatment for other medical conditions, due to alcohol abuse, may be necessary

How can Delirium Tremens be Prevented?

The prevention of Delirium Tremens may include the following factors:

  • The most important step in preventing DTs is seeking medical help from a qualified healthcare professional
  • The healthcare professional may recommend a “drying out” period when no alcohol is consumed while the individual is placed under continued professional care/medical supervision
  • Also, a complete avoidance of alcohol for rest of the life is advocated after the individuals have gone through a successful alcohol detoxification program
  • Persistent counseling and constant aid from support groups can help prevent alcoholism again

What is the Prognosis of Delirium Tremens? (Outcomes/Resolutions)

  • Delirium Tremens can be a very serious and life-threatening condition. Some symptoms, such as mood swings, fatigue, and sleeplessness, can last a year or longer
  • The prognosis of the condition with treatment is guarded or unpredictable. It can be evaluated on a case-by-case basis only

Additional and Relevant Useful Information for Delirium Tremens:

  • Alcohol withdrawal refers to the widespread symptoms that occur when individuals who are heavy drinkers cease the consumption of alcohol. The effects of alcohol withdrawal can range from mild to severely life-threatening symptoms

The following article link will help you understand alcohol withdrawal:

http://www.dovemed.com/diseases-conditions/alcohol-withdrawal/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 27, 2016
Last updated: May 21, 2018