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Delirium Tremens (DTs)

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%-10% of alcohol-dependent people experience DTs.

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 chances 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 1-3 days after suddenly stopping or decreasing alcohol intake. Symptoms may include:
  • Anxiety
  • Confusion
  • Delirium (changing levels of consciousness)
  • Trouble sleeping
  • Bad dreams
  • Severe agitation
  • Fever
  • Hallucinations (the perception of a thing or person that is not present)
  • Delusions (a false belief that is held strongly)
  • 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 5-7 days regardless of the therapy used. Clearing of DTs may begin in 12-24 hours but may take up to 2-10 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 oral or injected:
  • Fluids
  • Vitamin C
  • B-complex vitamins, including thiamin and folate
  • Magnesium
  • Glucose
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.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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