Symptoms and information about alcohol withdrawal delirium
Delirium Tremens (DT) is a severe and potentially life-threatening condition that can occur as a result of abrupt cessation or significant reduction of heavy and prolonged alcohol consumption. This condition is an extreme form of Alcohol Withdrawal Syndrome (AWS), characterised by extreme symptoms such as shaking, confusion, hallucinations, and seizures.
Timeline of Events Leading to DT
AWS symptoms typically begin within 6 to 24 hours after the last drink, starting with mild signs like tremors, anxiety, sweating, headache, nausea, and mood changes. Within 12 to 24 hours, these symptoms may progress to moderate symptoms including hallucinations and seizures. DT usually arises 48 to 72 hours after cessation.
Common Symptoms and Timeline
The onset of DT can vary, but it typically lasts 3-4 days but may continue for up to 8 days. Possible signs and symptoms of DT include visual hallucinations, profound confusion or disorientation, uncontrollable restless behaviour or agitation, rapid heart rate, breathing difficulties, high blood pressure, hyperthermia, and excessive or abnormal sweating.
Risk Factors Influencing Severity
The severity of DT can be influenced by several factors, including the amount and frequency of alcohol consumption, individual's physical health, weight, and age, as well as concurrent substance use or mental health disorders.
Treatments
Treatment for DT depends on medical supervision, medication (mainly benzodiazepines), supportive care, and sometimes inpatient detoxification to ensure safety and reduce mortality risk. Benzodiazepines, such as diazepam, chlordiazepoxide, and lorazepam, are the mainstay treatment for DT.
Prevention and Support
People concerned about their drinking can seek support from organisations like Alcoholics Anonymous (AA), LifeRing, SMART Recovery, and Women for Sobriety. Early screening and multidisciplinary intervention (including surgeons, addiction specialists, and social workers) improve outcomes, especially in patients undergoing surgery where AWS risk is significant.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides resources to learn more about Alcohol Use Disorder (AUD) and access local treatments. The Centers for Disease Control and Prevention (CDC) also offers resources to help people check their drinking habits and develop healthier choices. Delaying treatment for DT increases the risk of death, so it is crucial to seek help immediately if you or someone you know is experiencing symptoms of DT.
Diagnosis
A doctor will take a detailed medical history to assess the person's drinking habits, history of AWS, use of other substances, past or recent head injury, and history of psychiatric illness. They will also perform a physical examination to check for conditions that could complicate a diagnosis of DT, such as heart arrhythmias, congestive heart failure, coronary artery disease, gastrointestinal bleeding, infections, liver disease, pancreatitis, nervous system impairment, and other health issues. Lab tests, such as blood tests, liver function tests, and electrolyte tests, may also be ordered to check for DT or rule out other conditions.
In addition, a doctor may order an electrocardiogram (EKG) to assess heart rhythm during DT, an arterial blood gas analysis to check the blood's pH balance, an echocardiogram (echo) to check for heart disease, and a brain MRI to check for injury or swelling.
In summary, DT is a life-threatening condition that can occur as a result of abrupt cessation or significant reduction of heavy and prolonged alcohol consumption. Treatment depends on medical supervision, medication (mainly benzodiazepines), supportive care, and sometimes inpatient detoxification to ensure safety and reduce mortality risk. If you or someone you know is experiencing symptoms of DT, seek medical help immediately.
- The severity of Delirium Tremens (DT) can be influenced by factors such as the amount and frequency of alcohol consumption, concurrent substance use, mental health disorders, physical health, weight, and age.
- Treatment for DT often involves medical supervision, the use of benzodiazepines like diazepam, chlordiazepoxide, and lorazepam, supportive care, and sometimes inpatient detoxification to ensure safety and reduce mortality risk.
- Organizations like Alcoholics Anonymous (AA), LifeRing, SMART Recovery, and Women for Sobriety offer support for individuals concerned about their drinking habits, while early screening and multidisciplinary intervention can improve outcomes for those at risk of Alcohol Withdrawal Syndrome (AWS), especially during surgery.
