BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuDelirium tremensAlcohol abuse - delirium tremens; DTs; Alcohol withdrawal - delirium tremens; Alcohol withdrawal deliriumDelirium tremens is a severe form of alcohol withdrawal. It involves sudden and severe mental or nervous system changes.Alcohol withdrawalAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...Read Article Now Book Mark Article Causes Delirium tremens can occur when you stop drinking alcohol after a period of heavy drinking, especially if you do not eat enough food.Delirium tremens may also be caused by head injury, infection, or illness in people with a history of heavy alcohol use.It occurs most often in people who have a history of alcohol withdrawal. It is especially common in those who drink 4 to 5 pints (1.8 to 2.4 liters) of wine, 7 to 8 pints (3.3 to 3.8 liters) of beer, or 1 pint (1/2 liter) of "hard" alcohol every day for several months. Delirium tremens also commonly affects people who have used alcohol for more than 10 years. 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 may get worse quickly and can include:Agitation, irritability Body tremors Changes in mental function Deep sleep that lasts for a day or longer Sudden, severe confusion (delirium) Excitement or fear Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...Read Article Now Book Mark Article Seeing or feeling things that are not really there (hallucinations) HallucinationsHallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.Read Article Now Book Mark Article Bursts of energy Quick mood changes Mood changesDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article Restlessness RestlessnessAgitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.Read Article Now Book Mark Article Sensitivity to light, sound, touch Stupor, sleepiness, fatigueStuporDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Seizures (may occur without other symptoms of DTs):Most common in the first 12 to 48 hours after the last drink Most common in people with past complications from alcohol withdrawal Usually generalized whole body seizuresGeneralized whole body seizuresBilateral tonic-clonic seizure is a type of seizure that involves the entire body. It is also called grand mal seizure. The terms generalized seizu...Read Article Now Book Mark Article Symptoms of alcohol withdrawal, including: Anxiety, depression AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...Read Article Now Book Mark Article DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Headache HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...Read Article Now Book Mark Article Insomnia (difficulty falling and staying asleep) Irritability or excitability Loss of appetite Loss of appetiteA decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.Read Article Now Book Mark Article Nausea, vomiting NauseaNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...Read Article Now Book Mark Article Nervousness, jumpiness, shakiness, palpitations (sensation of feeling the heart beat) Pale skin Pale skinPaleness is an abnormal loss of color from normal skin or mucous membranes.Read Article Now Book Mark Article Rapid emotional changes Sweating, especially on the palms of the hands or the face SweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...Read Article Now Book Mark Article Other symptoms that may occur:Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.Read Article Now Book Mark Article Stomach painStomach painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.Read Article Now Book Mark Article Exams and Tests Delirium tremens is a medical emergency.The health care provider will perform a physical exam. Signs may include:Heavy sweating Increased startle reflex Irregular heartbeat Irregular heartbeatAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...Read Article Now Book Mark Article Problems with eye muscle movement Rapid breathing Rapid heart rate Rapid muscle tremors The following tests may be done:Blood magnesium level Blood magnesium levelA serum magnesium test measures the level of magnesium in the blood.Read Article Now Book Mark Article Blood phosphate level Blood phosphate levelThe phosphorus blood test measures the amount of phosphate in the blood.Read Article Now Book Mark Article Comprehensive metabolic panel Comprehensive metabolic panelA comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...Read Article Now Book Mark Article Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.Read Article Now Book Mark Article Electroencephalogram (EEG) ElectroencephalogramAn electroencephalogram (EEG) is a test to measure the electrical activity of the brain.Read Article Now Book Mark Article Toxicology screen (drug test)Toxicology screenA toxicology screen refers to various tests that determine the type and approximate amount of legal and illegal drugs a person has taken by measuring...Read Article Now Book Mark Article Treatment The goals of treatment are to:Save the person's life Relieve symptoms Prevent complications A hospital stay is needed. The health care team will regularly check:Blood test results, such as electrolyte levels ElectrolyteElectrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...Read Article Now Book Mark Article Body fluid levels Vital signs (temperature, pulse, breathing rate, blood pressure) Vital signsVital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...Read Article Now Book Mark Article While in the hospital, the person will receive medicines to:Stay calm and relaxed (sedated) until the DTs are finished Treat seizures, anxiety, or tremors Treat mental disorders, if any Long-term preventive treatment should begin after the person recovers from DT symptoms. This may involve:A "drying out" period, in which no alcohol is allowed Total and lifelong avoidance of alcohol (abstinence) Counseling Going to support groups (such as Alcoholics Anonymous) Treatment may be needed for other medical problems that can occur with alcohol use, including:Alcoholic cardiomyopathy (heart muscle disease) Alcoholic liver disease Alcoholic liver diseaseAlcoholic liver disease is damage to the liver and its function due to alcohol abuse.Read Article Now Book Mark Article Alcoholic neuropathy (brain and nerve disease) Alcoholic neuropathyAlcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.Read Article Now Book Mark Article Wernicke-Korsakoff syndrome (serious brain disease that results from vitamin B1 deficiency, which can be caused by heavy alcohol use)Wernicke-Korsakoff syndromeWernicke-Korsakoff syndrome is a brain disorder due to vitamin B1 (thiamine) deficiency.Read Article Now Book Mark Article Support Groups Attending a support group regularly is a key to recovering from alcohol use. More information and support for people with alcohol use disorder and their families can be found at:Support groupThe following organizations are good resources for information on alcohol use disorder:Centers for Disease Control and Prevention -- www. cdc. gov/al...Read Article Now Book Mark Article Alcoholics Anonymous -- www.aa.org Al-Anon Family Groups/Al-Anon/Alateen -- al-anon.org National Institute on Alcohol Abuse and Alcoholism -- www.niaaa.nih.gov SMART Recovery - www.smartrecovery.org/ Substance Abuse and Mental Health Services Administration -- www.samhsa.gov/atod/alcohol Outlook (Prognosis) Delirium tremens is serious and may be life-threatening. Some symptoms related to alcohol withdrawal may last for a year or more, including:Emotional mood swings Feeling tired Sleeplessness Possible Complications Complications can include:Injury from falls during seizures Injury to self or others caused by altered mental state (confusion/delirium) Irregular heartbeat, which may be life-threatening Seizures When to Contact a Medical Professional Go to the emergency room or call 911 or the local emergency number if you have symptoms. Delirium tremens is an emergency condition.If you go to the hospital for another reason, tell the providers if you've been drinking heavily so they can monitor you for symptoms of alcohol withdrawal. Prevention Avoid or reduce the use of alcohol. Get prompt medical treatment for symptoms of alcohol withdrawal.If you have a drinking problem, it is best to stop drinking alcohol completely. Total and lifelong avoidance of alcohol (abstinence) is the safest approach.Open ReferencesReferencesKelly JF, Renner JA. Alcohol-related disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 26.O'Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 30.AllVideoImagesTogRelated Information Psychosis(Condition)Seizures(Symptoms)Alcohol withdrawal(Condition)Alcohol use disorder(Condition)Alcohol use disorders - InDepth(In-Depth) Review Date: 2/28/2023 Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Delirium tremensAlcohol abuse - delirium tremens; DTs; Alcohol withdrawal - delirium tremens; Alcohol withdrawal deliriumDelirium tremens is a severe form of alcohol withdrawal. It involves sudden and severe mental or nervous system changes.Alcohol withdrawalAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...Read Article Now Book Mark Article Causes Delirium tremens can occur when you stop drinking alcohol after a period of heavy drinking, especially if you do not eat enough food.Delirium tremens may also be caused by head injury, infection, or illness in people with a history of heavy alcohol use.It occurs most often in people who have a history of alcohol withdrawal. It is especially common in those who drink 4 to 5 pints (1.8 to 2.4 liters) of wine, 7 to 8 pints (3.3 to 3.8 liters) of beer, or 1 pint (1/2 liter) of "hard" alcohol every day for several months. Delirium tremens also commonly affects people who have used alcohol for more than 10 years. 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 may get worse quickly and can include:Agitation, irritability Body tremors Changes in mental function Deep sleep that lasts for a day or longer Sudden, severe confusion (delirium) Excitement or fear Fever FeverFever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...Read Article Now Book Mark Article Seeing or feeling things that are not really there (hallucinations) HallucinationsHallucinations involve sensing things such as visions, sounds, or smells that seem real but are not. These things are created by the mind.Read Article Now Book Mark Article Bursts of energy Quick mood changes Mood changesDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article Restlessness RestlessnessAgitation is an unpleasant state of extreme arousal. An agitated person may feel stirred up, excited, tense, confused, or irritable.Read Article Now Book Mark Article Sensitivity to light, sound, touch Stupor, sleepiness, fatigueStuporDecreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...Read Article Now Book Mark Article FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Seizures (may occur without other symptoms of DTs):Most common in the first 12 to 48 hours after the last drink Most common in people with past complications from alcohol withdrawal Usually generalized whole body seizuresGeneralized whole body seizuresBilateral tonic-clonic seizure is a type of seizure that involves the entire body. It is also called grand mal seizure. The terms generalized seizu...Read Article Now Book Mark Article Symptoms of alcohol withdrawal, including: Anxiety, depression AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...Read Article Now Book Mark Article DepressionDepression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for shor...Read Article Now Book Mark Article Fatigue FatigueFatigue is a feeling of weariness, tiredness, or lack of energy.Read Article Now Book Mark Article Headache HeadacheA headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...Read Article Now Book Mark Article Insomnia (difficulty falling and staying asleep) Irritability or excitability Loss of appetite Loss of appetiteA decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.Read Article Now Book Mark Article Nausea, vomiting NauseaNausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...Read Article Now Book Mark Article Nervousness, jumpiness, shakiness, palpitations (sensation of feeling the heart beat) Pale skin Pale skinPaleness is an abnormal loss of color from normal skin or mucous membranes.Read Article Now Book Mark Article Rapid emotional changes Sweating, especially on the palms of the hands or the face SweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...Read Article Now Book Mark Article Other symptoms that may occur:Chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.Read Article Now Book Mark Article Stomach painStomach painAbdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.Read Article Now Book Mark Article Exams and Tests Delirium tremens is a medical emergency.The health care provider will perform a physical exam. Signs may include:Heavy sweating Increased startle reflex Irregular heartbeat Irregular heartbeatAn arrhythmia is a disorder of the heart rate (pulse) or heart rhythm. The heart can beat too fast (tachycardia), too slow (bradycardia), or irregul...Read Article Now Book Mark Article Problems with eye muscle movement Rapid breathing Rapid heart rate Rapid muscle tremors The following tests may be done:Blood magnesium level Blood magnesium levelA serum magnesium test measures the level of magnesium in the blood.Read Article Now Book Mark Article Blood phosphate level Blood phosphate levelThe phosphorus blood test measures the amount of phosphate in the blood.Read Article Now Book Mark Article Comprehensive metabolic panel Comprehensive metabolic panelA comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...Read Article Now Book Mark Article Electrocardiogram (ECG) ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.Read Article Now Book Mark Article Electroencephalogram (EEG) ElectroencephalogramAn electroencephalogram (EEG) is a test to measure the electrical activity of the brain.Read Article Now Book Mark Article Toxicology screen (drug test)Toxicology screenA toxicology screen refers to various tests that determine the type and approximate amount of legal and illegal drugs a person has taken by measuring...Read Article Now Book Mark Article Treatment The goals of treatment are to:Save the person's life Relieve symptoms Prevent complications A hospital stay is needed. The health care team will regularly check:Blood test results, such as electrolyte levels ElectrolyteElectrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...Read Article Now Book Mark Article Body fluid levels Vital signs (temperature, pulse, breathing rate, blood pressure) Vital signsVital signs reflect essential body functions, including your heartbeat, breathing rate, temperature, and blood pressure. Your health care provider m...Read Article Now Book Mark Article While in the hospital, the person will receive medicines to:Stay calm and relaxed (sedated) until the DTs are finished Treat seizures, anxiety, or tremors Treat mental disorders, if any Long-term preventive treatment should begin after the person recovers from DT symptoms. This may involve:A "drying out" period, in which no alcohol is allowed Total and lifelong avoidance of alcohol (abstinence) Counseling Going to support groups (such as Alcoholics Anonymous) Treatment may be needed for other medical problems that can occur with alcohol use, including:Alcoholic cardiomyopathy (heart muscle disease) Alcoholic liver disease Alcoholic liver diseaseAlcoholic liver disease is damage to the liver and its function due to alcohol abuse.Read Article Now Book Mark Article Alcoholic neuropathy (brain and nerve disease) Alcoholic neuropathyAlcoholic neuropathy is damage to the nerves that results from excessive drinking of alcohol.Read Article Now Book Mark Article Wernicke-Korsakoff syndrome (serious brain disease that results from vitamin B1 deficiency, which can be caused by heavy alcohol use)Wernicke-Korsakoff syndromeWernicke-Korsakoff syndrome is a brain disorder due to vitamin B1 (thiamine) deficiency.Read Article Now Book Mark Article Support Groups Attending a support group regularly is a key to recovering from alcohol use. More information and support for people with alcohol use disorder and their families can be found at:Support groupThe following organizations are good resources for information on alcohol use disorder:Centers for Disease Control and Prevention -- www. cdc. gov/al...Read Article Now Book Mark Article Alcoholics Anonymous -- www.aa.org Al-Anon Family Groups/Al-Anon/Alateen -- al-anon.org National Institute on Alcohol Abuse and Alcoholism -- www.niaaa.nih.gov SMART Recovery - www.smartrecovery.org/ Substance Abuse and Mental Health Services Administration -- www.samhsa.gov/atod/alcohol Outlook (Prognosis) Delirium tremens is serious and may be life-threatening. Some symptoms related to alcohol withdrawal may last for a year or more, including:Emotional mood swings Feeling tired Sleeplessness Possible Complications Complications can include:Injury from falls during seizures Injury to self or others caused by altered mental state (confusion/delirium) Irregular heartbeat, which may be life-threatening Seizures When to Contact a Medical Professional Go to the emergency room or call 911 or the local emergency number if you have symptoms. Delirium tremens is an emergency condition.If you go to the hospital for another reason, tell the providers if you've been drinking heavily so they can monitor you for symptoms of alcohol withdrawal. Prevention Avoid or reduce the use of alcohol. Get prompt medical treatment for symptoms of alcohol withdrawal.If you have a drinking problem, it is best to stop drinking alcohol completely. Total and lifelong avoidance of alcohol (abstinence) is the safest approach.Open ReferencesReferencesKelly JF, Renner JA. Alcohol-related disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 26.O'Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 30.