Definition

Delirium tremens (DTs) is a severe disturbance of the brain caused by alcohol withdrawal. This condition is serious and can cause death. About 5% of alcohol-dependent people experience DTs.

Adult Brain

Brain Man Face

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

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for DTs include:

  • History of DTs
  • Other medical problems in addition to alcohol abuse
  • Brain damage

Symptoms

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

  • Anxiety
  • Confusion
  • Delirium (alternating levels of consciousness)
  • Trouble sleeping
  • Bad dreams
  • Severe agitation
  • Fever
  • Hallucinations (the perception of a thing, voice, or person that is not present)
  • 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, and perform a physical exam. The diagnosis of DTs is usually based on the symptoms and signs of the disorder. Tests may include:

  • Blood tests to measure liver function or electrolytes
  • CT scan of the brain—a type of x-ray that uses a computer to make pictures of the inside of the brain

Treatment

Treatment can be difficult. DTs are likely to last for 5 to 7 days regardless of the therapy used. Clearing of DTs may begin in 12 to 24 hours, but may take up to 2 to10 days. Treatment for alcohol abuse is necessary once DTs are under control.

Treatment may include:

Medication

Medications may include:

  • Sedatives (such as benzodiazepines) to:
    • Calm agitation
    • Ease withdrawal symptoms
  • Aspirin or acetaminophen to lower fever

Vitamins and Fluids

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

  • Intravenious fluids, magnesium, and glucose
  • Intravenous doses of vitamin C and B-complex vitamins, including thiamin

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 such as Alcoholics Anonymous (AA).

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.