The condition delirium tremens (DTs) occurs when someone who is dependent on alcohol suddenly stops drinking. This condition affects the brain and nervous system as a result of alcohol withdrawal syndrome. This blog post explains why delirium tremens occurs, what its symptoms are, how to diagnose it, how to treat it, and how to prevent it.
It is caused by a sudden change in alcohol levels in the body that causes delirium tremens. As a depressant, alcohol slows down the central nervous system (CNS), which controls vital functions such as breathing, heart rate, blood pressure, and temperature, in the body. It is called tolerance when the CNS adjusts to alcohol consumption and increases its own activity in order to maintain its normal balance.
The CNS is overstimulated without alcohol to counteract it if a person suddenly stops drinking or reduces their alcohol intake significantly. As a result, withdrawal can cause a range of physical and mental symptoms that can be very distressing and dangerous.
It usually occurs within two to four days after the last drink, but it can sometimes take up to ten days to develop. Delirium tremens is the most severe form of alcohol withdrawal. People with a history of heavy, long-term alcohol use are more likely to suffer from it, particularly those with a history of alcohol withdrawal, seizures, or other brain or liver conditions.
Dementia tremens affects both the body and the mind. The main symptom is delirium, which is a state of confusion and altered consciousness that makes it impossible to think clearly, remember things, or be aware of one's surroundings.
Tremors or shaking, especially in the hands and feet
Agitation, anxiety, or irritability
Hallucinations, or seeing, hearing, or feeling things that are not there
Paranoia, or feeling suspicious or fearful of others
Disorientation, or losing track of time, place, or identity
Sleep problems, such as insomnia, nightmares, or excessive sleepiness
Fever, sweating, or chills
High blood pressure, rapid heart rate, or irregular heartbeat
Nausea, vomiting, or diarrhea
Seizures, or sudden and uncontrollable muscle spasms
In addition to dehydration, electrolyte imbalance, infection, bleeding, organ failure, coma, or death, delirium tremens can also cause serious complications.
Doctors can diagnose delirium tremens by looking at a person's medical history, the timing and severity of the symptoms, as well as the results of a physical examination and some tests.
How much and how often the person drinks alcohol
When the person had their last drink
Whether the person has tried to quit or cut down on drinking before
Whether the person has any other medical conditions or takes any medications
Whether the person has any allergies or drug sensitivities
As part of the physical examination, the doctor may check the person's vital signs, including temperature, blood pressure, heart rate, and breathing. He may also look for signs of dehydration, infection, or injury, and examine the person's eyes, skin, and nervous system.
The doctor may also order some tests to rule out other possible causes of the symptoms, such as infection, head injury, stroke, or drug overdose. These tests may include:
Blood tests, to measure the level of alcohol and other substances in the blood, and to check the function of the liver, kidneys, and other organs
Urine tests, to detect the presence of alcohol or other drugs in the urine
Breath tests, to measure the amount of alcohol in the breath
Electrocardiogram (ECG), to monitor the electrical activity of the heart
Electroencephalogram (EEG), to record the electrical activity of the brain
Brain imaging, such as computed tomography (CT) scan or magnetic resonance imaging (MRI), to look for any abnormalities or damage in the brain
The doctor may also use a questionnaire called the Clinical Institute Withdrawal Assessment (CIWA), which is a tool to assess the severity of the alcohol withdrawal symptoms and to guide the treatment.
Delirium tremens is a serious and potentially fatal condition that requires immediate and intensive treatment in a hospital. The main goals of the treatment are to:
Stabilize the person’s vital signs and prevent complications
Relieve the person’s symptoms and reduce the risk of seizures
Restore the person’s hydration and nutrition
Support the person’s recovery and prevent relapse
The treatment may involve:
Benzodiazepines, a sedative that calms the nervous system and reduces the symptoms of delirium tremens, can also be used to treat or prevent seizures. As well as antipsychotics, anticonvulsants, and beta blockers, other medications may be prescribed for specific symptoms or complications.
Fluids and electrolytes, which are given intravenously (through a vein) to correct dehydration and electrolyte imbalance, and to prevent or treat shock or organ failure.
Nutritional supplements, such as thiamine, that are given intravenously or orally to prevent or treat nutritional deficiencies, especially those that affect the brain or nervous system.
The patient's vital signs, symptoms, and response to treatment are continuously monitored and observed. If the patient has trouble breathing or maintaining adequate blood oxygen levels, they may also need oxygen therapy, mechanical ventilation, or other supportive measures.
An emotional and mental impact of delirium tremens can be alleviated with psychological support provided by a team of health professionals, including doctors, nurses, social workers, and counselors. Additionally, they help the person prevent relapses and plan for long-term recovery.
In order to avoid delirium tremens, people with alcohol use disorders should seek professional help to quit or reduce their alcohol consumption. A variety of options and resources are available to help people with alcohol use disorders, such as:
Under medical supervision, detoxification is a process of safely reducing alcohol levels in the body. Depending on the individual's needs and preferences, detoxification can be performed in a hospital or as an outpatient, which can help prevent or minimize withdrawal symptoms, including delirium tremens.
Medications such as naltrexone, acamprosate, and disulfiram, which can reduce the craving for alcohol as well as prevent relapse by dissuading the person from drinking.
It is possible to develop coping skills and strategies to deal with stress, triggers, and cravings through counseling and therapy, which are forms of psychological treatment. A person's self-esteem, relationships, and quality of life can also be improved as a result of them.
Alcoholics Anonymous (AA) is a peer-led group that provides mutual support and encouragement to people seeking to quit or reduce alcohol consumption.
An alcohol use disorder can be treated with rehabilitation programs, which offer a combination of medical, psychological, and social services to help the individual recover from the disorder. Depending on the individual's needs and preferences, they may be residential or outpatient.
If you or someone you know has a problem with alcohol, you should seek help as soon as possible. There is no shame in seeking help, and there is hope for recovery. You are not alone.
