Delirium Tremens: Symptoms and Treatment Strategies

Delirium tremens are treatable if proper medical care is sought immediately and no comorbid medical conditions or complications exist. The mainstay of treatment is medications used to lower the overactive nervous system in order to control heart rate and blood pressure and prevent seizures. Sedating medications such as benzodiazepines are the mainstay treatment for delirium tremens as benzodiazepines act on the same GABA receptors as alcohol and are known to induce a calming nervous system. The type, amount, and frequency of benzodiazepines administered depends on the severity of symptoms and the person’s past history. In general, for DTs, high doses of diazepam are given intravenously until the person is calm but alert, and then dosages are gradually tapered.

Assessment of Delirium Tremens

Delirium Tremens (DTs) is a severe form of alcohol withdrawal that occurs in about 5% of those undergoing detoxification, as per the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This condition can be life-threatening, with up to a 15% mortality rate without medical treatment. What is Delirium Tremens It typically arises after prolonged heavy alcohol use when drinking is suddenly stopped. Immediate medical intervention is critical to manage and mitigate the severe outcomes of DTs. It is estimated that approximately 1% of individuals with alcohol use disorder may experience delirium tremens. If left untreated, delirium tremens can lead to serious symptoms such as heart attack, stroke, and even death.

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• The clinical manifestations of ethanol withdrawal are divided into four overlapping syndromes i.e. acute alcoholic tremulousness, withdrawal seizures, alcoholic hallucination and delirium tremens.
• Blood tests may also be performed to evaluate electrolyte imbalances, liver function, and to rule out infections.
• In this article, we’ll cover Delirium tremens and how to deal with them.
• Most people can slowly return to daily activities after proper recovery.
• Ideally, a person receiving treatment for alcohol withdrawal will receive care designed to prevent DTs from appearing.

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Rare Symptoms and Complications

Assessment of DT which has been discussed before forms the backbone of its management. The only cause of DTs is withdrawal that happens when someone with alcohol use disorder stops drinking alcohol suddenly. They usually appear between one and three days after your last drink and are usually most intense four to five days after your last drink. When you’re in residential treatment, everything is structured to drug addiction give you the best chance at lasting recovery.

• Families can provide the necessary emotional support and motivation needed for an individual to pursue and adhere to treatment plans.
• Support systems should also focus on treating any coexisting addictions, which can complicate recovery and lead to further relapse.
• Therefore, timely medical treatment is crucial to manage these risks and prevent serious consequences.
• Monitoring vitamins and electrolytes is important, especially thiamine to prevent Wernicke-Korsakoff Syndrome.

One of the major risks with DTs is seizures, so the medical team will be prepared to manage that if it happens. Talking to a therapist, joining a support group, or entering a rehab program will give you the tools you need to manage alcohol withdrawal and stay sober in the future. The stress of withdrawal, combined with the raised heart rate and high blood pressure, can lead to serious issues like heart attacks or arrhythmias (irregular heartbeats). At Mississippi Drug and Alcohol Treatment Center, we offer a medically supervised detox program designed to protect your health and lay the foundation for lasting recovery. Our team is here to help you transition safely and confidently into the next phase of treatment. Without prompt treatment, it can lead to complications like cardiac arrest, respiratory failure, or death.

• The symptoms fluctuated markedly at short intervals and 2 patients (14.2%) had no features of sympathetic overactivity.
• Due to this confounding clinical presentation, it is incredibly important for clinicians to maintain a high suspicion for alcohol withdrawal.
• For individuals at risk of delirium tremens, Porch Light Health offers Ambulatory Medically Supervised Withdrawal Services (AMSWS), providing safe medical supervision during the critical detoxification period.
• All relevant haematological and biochemical investigations were performed and the patients were followed up during their hospitalisation for problems encountered in management and response to treatment.

The type of alcohol also influences the alcohol related harmful effects. As mentioned previously, DT usually develops 48–72 h after the last drink. Therefore, it is important to elicit the information in terms of time since last drink. History of previous alcohol withdrawal should also be obtained, as past history of DT or withdrawal seizure increase the risk of DT in the present episode. History should also focus on obtaining information with regard to head injury (recent or past), baseline cognitive functioning and comorbid psychiatric disorders.

For males, that means drinking three or more drinks per day and 15 or more drinks per week. For females, that means drinking two or more drinks per day and eight or more drinks per week. However, DTs becomes more and more likely the more you drink and the longer this continues. Because of these symptoms, you won’t be able to make decisions about your medical care. Healthcare providers will treat you to stabilize you (unless you have some kind of advance medical directive on file with them). They may also talk to family, friends or loved ones you previously approved to know and make decisions about your medical care.