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Understanding Delirium Tremens (DTs): Causes, symptoms and treatment

Team AckoDec 13, 2023

Trying to quit alcohol abruptly can adversely affect the well-being of an individual. The sudden abstinence from alcohol can lead to withdrawal, which can cause a life-threatening condition called Delirium Tremens.

It is vital to identify early signs of this health issue, as it can become fatal if timely action is not taken. Read on to know the symptoms, causes, treatment, and prevention methods of this condition.

Contents

What is Delirium Tremens?
Symptoms of Delirium Tremens
Causes of Delirium Tremens
Complications of Delirium Tremens
Delirium Tremens diagnosis
Treatment of Delirium Tremens
How to prevent Delirium Tremens
Frequently Asked Questions (FAQs)

What is Delirium Tremens?

Delirium Tremens (DTs) is a potentially severe condition that can occur when a person suddenly stops alcohol intake after drinking heavily for a long period of time. It is also known as alcohol withdrawal delirium (AWD). It typically occurs within 2 to 3 days after a person stops drinking. It lasts for 2 to 3 days, but a person may experience a few signs that may extend for a week.

Symptoms of Delirium Tremens

Signs of Delirium Tremens may include the following.

Anxiety
Auditory or visual hallucinations
Body tremors
Agitation
Changes in blood pressure and heart rate
Severe confusion
Diarrhoea
Chest pain
Loss of appetite
Dehydration
Fatigue
Fever
Rapid emotional change
Sensitivity to touch, light, and sound
Heavy sweating
Deep sleep that lasts for a day or longer
Hallucinations
Headache
Nausea
Vomiting
Nightmares
Bursts of energy
Pale skin
Trouble breathing

These signs may get worse quickly. So, timely action is required to start the treatment.

Causes of Delirium Tremens

It is common among people who are heavy drinkers. For men, heavy drinking is 15 drinks a week. For women, it is 8 or more drinks per week.

Those who are long-term drinkers (for more than 10 years) usually face this problem. However, this condition is most common in those who have gone through alcohol withdrawal before. Apart from these, people who have a history of seizures experience it as well. It can also be caused by a head injury or infection.

Complications of Delirium Tremens

Alcohol use affects the nervous system, which slows down the brain's functioning. The brain adapts to the process of consuming alcohol, and eventually the individual develops a dependency on alcohol. When the individual stops or reduces alcohol intake, the brain gets overstimulated. This causes a state when the body starts showing signs of alcohol withdrawal. If the symptoms become severe, then the condition may lead to other complications, which are as follows.

1. Alcoholic cardiomyopathy

In this condition, the heart changes its shape and leads to severe problems. It also causes hearing loss as a result of prolonged alcohol usage. If this condition can't be treated, a heart transplant would be an option.

2. Wernicke-Korsakoff syndrome

It is also called Korsakoff's amnesic syndrome. It is a brain condition that is linked to heavy drinking. It causes lasting damage to cells in the spinal cord and brain, including the memory-related part. A doctor will suggest vitamin B1 to treat muscle aches. But memory loss is usually permanent.

3. Alcohol-related liver disease

It is also called alcoholic fatty liver disease. It develops as a result of years of heavy drinking. It causes liver cirrhosis and scarring. Timely treatment is essential; otherwise, it will lead to renal failure and liver cancer.

4. Alcoholic neuropathy

It is referred to as "damage to the nerves" that is caused by heavy drinking and is a permanent condition. Painful sensations, tingling in the limbs, and reduced mobility are some of its signs.

Delirium Tremens diagnosis

The diagnosis of Delirium Tremens (DTs) is usually made based on a person's history and symptoms. Also, a doctor may conduct a physical exam and see if you have any signs, including the following.

Irregular heart rate
Hand tremors
Dehydration

Further, your doctor may perform a toxicology screen test, which shows the amount of alcohol present in your body. This screening test is done with a urine or blood sample. Apart from these, your doctor may order the following tests to assess the severity.

1. Blood phosphate level

It is evaluated in a blood test, and low levels of phosphate exhibit alcoholism.

2. Blood magnesium level or serum magnesium level

It's a quick blood test that is used to determine the blood magnesium level. Low magnesium levels are a sign of severe alcohol withdrawal.

3. Comprehensive metabolic panel

The abnormal result of this blood test is a clear indication of alcoholism. It also provides information about liver function, kidney function, and blood sugar levels.

4. EEG (electroencephalogram)

It measures the electrical activity in the brain and can be used to assess those facing serious alcohol withdrawals.

5. ECG (electrocardiograph)

It measures the electrical activity in the heart and can evaluate the severity of withdrawal.

6. Lumbar puncture test

It is used to examine or remove spinal cord fluid.

7. Metabolic panel

This test measures different substances in your blood, such as sodium, potassium, calcium, potassium, and more.

Treatment of Delirium Tremens

Delirium Tremens is a serious and life-threatening condition that needs immediate medical attention. Treatment usually begins in the emergency room, where individuals are closely monitored around the clock.

Depending on the severity of the DTs, individuals may be treated with medication to help control the symptoms. Medications used to treat the condition may include the following.

Benzodiazepines
Antipsychotics
Pain medication
Drugs to regulate heartbeat
Anticonvulsants
Blood pressure medication

In severe cases, individuals may need to be intubated and placed on a ventilator to assist with breathing. Once the individual is stabilised, they will be transferred to a regular hospital room and monitored closely. Treatment for DTs often lasts for 3 to 5 days. During this time, the person will be given IV fluids and nutrients to help prevent dehydration.

The individual will also be monitored for any signs of relapse. If Delirium Tremens do occur, doctors will restart the treatment. The individual may need to be hospitalised for a week. After being discharged from the hospital, the individual will need to follow up with their doctor and continue treatment as directed. Treatment for Delirium Tremens may include medication, rehabilitation, lifestyle changes, and treatment for alcohol-related conditions.

It is vital to note that it is a medical emergency and can become fatal when left untreated. If you or someone you know is showing signs or symptoms of DTs, seek medical help immediately.

How to prevent Delirium Tremens

There are a few things you can do to lower your risk of contracting DTs or lessen the symptoms if you do develop this condition. You can count on the following ways.

Avoid drinking alcohol in large quantities and on an empty stomach.
If you are taking certain medications, you should avoid drinking alcohol.
Get enough rest and sleep.
Consume a healthy diet.
Drink plenty of fluids, especially water.

If you are experiencing alcohol withdrawal symptoms and have a higher risk of developing seizures, seek medical treatment without any delay.

Frequently Asked Questions (FAQs)

Listed below are some of the common questions related to Delirium Tremens.

How long do DTs usually last?

It lasts for 24 hours to 6 days, and in rare cases, it can last for weeks.

How does Delirium Tremens lead to death?

This condition requires prompt care, and its short-term effects can be life-threatening. If left untreated, an individual may experience seizures, hallucinations, dehydration, and changes in blood pressure and heart rate. All these symptoms can be fatal.

Is Delirium Tremens a psychiatric emergency?

It is a medical emergency. Some individuals get discharged after the complete resolution of DTs, while others receive comprehensive in-patient addiction treatment, depending on the case.

Is Delirium Tremens reversible?

It is not a permanent condition, but it is life-threatening. Recovery of brain function is possible, but complete recovery can be harder. It totally depends on the individual’s case. If someone continues to drink after rehabilitation, then there are higher chances of experiencing DTs again in the future.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.