Carl R. Darnall Army Medical Center - Health Library

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.

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Causes ^

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

Risk Factors ^

Your chances of DTs are higher if:

  • You're a heavy drinker or have a past problem with alcohol use disorder (AUD)
  • You've had DTs or other withdrawal problems in the past
  • You have other health problems outside of AUD

Symptoms ^

Symptoms start within 3-7 days once drinking stops or the amount is lowered. You may have:

  • Tremors of the hands, head, or body
  • Anxiety
  • Agitation
  • Sweating
  • Fast heartbeat—tachycardia
  • Fever
  • Nausea or vomiting
  • Sleeping problems
  • Bad dreams
  • Seizures
  • Hallucinations—seeing or hearing things that aren't there

If left untreated, DTs can result in death.

Diagnosis ^

You will be asked about your symptoms and health history. Your answers and a physical exam may point to withdrawal. You may have:

  • 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 ^

The goals are to:

  • Ease symptoms
  • Avoid complications
  • Get treated for AUD

Clearing of DTs depends on how severe your problems are. It may start in 12-24 hours, but it can take up to 7 days.

Medicines

DTs may be treated with medicines used to control:

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

Vitamins and Fluids

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

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 ^

To prevent having DTs, drink in moderation. If you do drink large amounts on a regular basis, don't suddenly stop or reduce the amount on your own. Call your doctor. They will help you lower your intake safely.

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 Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114807/Alcohol-withdrawal-syndrome. Updated January 17, 2017. Accessed August 21, 2018.

Alcohol withdrawal treatment, symptoms, and timeline. American Addiction Centers website. Available at: https://americanaddictioncenters.org/withdrawal-timelines-treatments/alcohol. Accessed August 21, 2018.

Barrons R, Roberts N. The role of carbamazepine and oxcarbazepine in alcohol withdrawal syndrome. J Clin Pharm Ther. 2010;35(2):153-67.

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

McKeon A, Frye MA, Delanty N. The alcohol withdrawal syndrome. J Neurol Neurosurg Psych. 2008;79(8):854-862.

Last reviewed June 2018 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 8/21/2018