Delirium Tremens

(DTs)

Definition

Delirium tremens (DTs) is a severe problem with how the brain works.

Adult Brain

Brain Man Face
The sudden withdrawal or decrease of alcohol can cause severe disturbances in the brain.
Copyright © Nucleus Medical Media, Inc.

Causes

People who drink large amounts of alcohol get DTs when they stop drinking. This can also happen when the intake is suddenly lowered.

Risk Factors

Things that may raise the risk of this problem are:

  • Drinking heavily or having a past problem with alcohol use disorder (AUD)
  • Prior DTs or other withdrawal problems
  • Having other health problems

Symptoms

Symptoms start within 3 to 7 days once drinking stops or the amount is lowered. Problems may be:

  • Tremors of the hands, head, or body
  • Agitation
  • Sweating
  • Fast heartbeat
  • Fever
  • Nausea or vomiting
  • Sleeping problems
  • Seeing or hearing things that are not there

Diagnosis

You will be asked about your symptoms and health history. You will also be asked about your alcohol use. A physical exam will be done. This may be enough to make the diagnosis.

Other tests that may be done are:

  • Blood tests
  • EEG —to test brain activity
  • MRI scan —to check a head injury or if you had seizures
  • Lumbar puncture —to check the fluid that protects the brain and spinal cord

Treatment

DTs can be deadly. The goal of treatment is to:

  • Ease symptoms
  • Avoid health problems from DTs
  • Get treated for AUD

Treatment depends on how severe symptoms are. It may start in 12 to 24 hours, but it can take up to 7 days. Choices are:

Medicines

DTs may be treated with medicines used to ease:

  • Pain
  • Anxiety, withdrawal, and problems with thinking
  • Blood pressure and heart rate
  • Seizures
  • Hallucinations or other mental problems

Vitamins and Fluids

Lack of vitamins and dehydration are common in more severe forms. They can be treated with:

Rehabilitation

AUD may be treated in a hospital or at home. It may involve single or group therapy. Many people seek support by joining groups such as Alcoholics Anonymous (AA).

Prevention

The risk of this problem can be lowered by drinking alcohol in moderation.

RESOURCES:

Alcoholics Anonymous
https://www.aa.org
National Institute on Alcohol Abuse and Alcoholism
https://www.niaaa.nih.gov

CANADIAN RESOURCES:

Alcoholics Anonymous—Halifax Regional Municipality
http://www.aahalifax.org
Canadian Centre on Substance Use and Addiction
http://www.ccsa.ca

References:

Alcohol withdrawal syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/alcohol-withdrawal-syndrome. Accessed October 21, 2020.
Alcohol withdrawal symptoms, treatment, and timeline. American Addiction Centers website. Available at: https://americanaddictioncenters.org/withdrawal-timelines-treatments/alcohol. Accessed October 21, 2020.
Sachdeva A, Choudhary M, et al. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. J Clin Diagn Res. 2015 Sep;9(9):VE01-VE07.
Last reviewed September 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 10/21/2020

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