Delirium Tremens: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Delirium Tremens?
An emergency doctor or a hospitalist treats delirium tremens. A hospitalist is a doctor who cares for hospital patients. An addiction medicine doctor or a psychiatrist, a mental health doctor, can help you stay sober. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is delirium tremens?
Delirium tremens, also called DTs, is a severe form of alcohol withdrawal. It involves sudden and severe mental or nervous system changes. Alcohol withdrawal means symptoms that may occur when a person who drinks too much alcohol on a regular basis suddenly stops. DTs are serious and may be life-threatening.
Symptoms
Symptoms most often occur within 48 to 96 hours after the last drink. But they may occur 7 to 10 days after the last drink. Symptoms can get worse fast and can include:
- You may feel agitated and easily upset.
- Body tremors, which means shaking you cannot control.
- You may have sudden, severe confusion, which is called delirium.
- You may see or feel things that are not really there. These are called hallucinations.
- You may have a fever.
- You may feel excited or afraid.
- Light, sound, and touch may bother you more than usual.
Seizures may also occur, even without other signs of DTs. Seizures are most common in the first 12 to 48 hours after the last drink. Other symptoms that may occur are chest pain and stomach pain.
Alcohol withdrawal symptoms tend to occur within 8 hours after the last drink, but can occur days later.
Causes and who gets it
DTs can occur when you stop drinking alcohol after a period of heavy drinking, especially if you do not eat enough food. A head injury, an infection, or an illness can also trigger it in people with a history of heavy alcohol use. It occurs most often in people who have a history of alcohol withdrawal. DTs also commonly affect people who have used alcohol for more than 10 years. The more often you drink, the more likely you are to have withdrawal symptoms when you stop. Withdrawal may be more severe if you have certain other medical problems.
How doctors diagnose it
Your health care provider will do a physical exam. Signs may include heavy sweating, a fast heart rate, fast breathing, an uneven heartbeat, and fast muscle tremors. Doctors may also see an increased startle reflex and problems with eye muscle movement.
Some tests may be done:
- Blood tests for magnesium and phosphate, which are body minerals.
- A metabolic panel, a blood test that checks body chemicals.
- An ECG, a test that records the electrical activity of the heart.
- An EEG, a test that records the electrical activity of the brain.
- A toxicology screen, which is a drug test.
Treatment
The goals of treatment are to save the person's life, relieve symptoms, and prevent complications. A hospital stay is needed. The health care team regularly checks blood tests, body fluid levels, and vital signs, such as temperature, pulse, and blood pressure. In the hospital, you will get medicines to stay calm and relaxed until the DTs are finished. Other medicines help with seizures, worry, or shaking.
Long-term treatment should begin after the person recovers from symptoms. It may include a drying out period with no alcohol, counseling, and support groups like Alcoholics Anonymous. Total and lifelong avoidance of alcohol is advised. You may also need care for other health problems linked to alcohol, such as liver disease.
When to see a doctor
Go to the emergency room or call 911 or the local emergency number if you have symptoms. DTs are an emergency. You might be in alcohol withdrawal if you drank often and recently stopped. If so, contact your provider right away or go to the emergency room. If you go to the hospital for another reason, tell your providers if you have been drinking heavily. If you are thinking about harming yourself, call or text 988 (the Suicide and Crisis Lifeline) right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Because DTs are an emergency, they need hospital care first. Afterward, either can help with follow-up, counseling referrals, and care for related health problems.
Common questions
When does delirium tremens start?
Symptoms most often start within 48 to 96 hours after the last drink. In some people they start 7 to 10 days after the last drink.
Is delirium tremens life-threatening?
Yes, delirium tremens is serious and may be life-threatening. An irregular heartbeat can also be life-threatening.
Can delirium tremens be treated at home?
No, a hospital stay is needed for delirium tremens. Mild-to-moderate alcohol withdrawal can often be treated outside a hospital. You will need someone to stay with you and keep an eye on you.
How can delirium tremens be prevented?
Prevention starts with cutting back on alcohol or not drinking at all. It also helps to get prompt medical treatment for symptoms of alcohol withdrawal. If you drink heavily, stopping can trigger delirium tremens.
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Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
