Delirium tremens, often called DTs, are among the most severe and life-threatening manifestations of alcohol withdrawal. DT doesn’t occur with minimal alcohol consumption, but as a consequence of heavy and regular drinking. DTs are a serious manifestation affecting people with severe and chronic alcoholism. DTs are often accompanied with unbearable discomfort due to alcohol withdrawal, and can be a distressing process to undergo or to witness. It comes with uncontrollable shaking, disorientation, anxiety, hallucination, and other excruciating symptoms.
Withdrawal symptoms can be relatively mild for some. However, about 5% to 10% of people with severe and chronic alcoholism suffer from life-threatening manifestations. Life-threatening manifestations are less common, but people tormented by severe withdrawal symptoms need to seek immediate professional care to effectively detox and avoid fatal consequences.
Keep reading for further details of the symptoms to look out for knowing when delirium tremens occur, down to the causes, risk factors, and treatment.
Since DT is one of the most severe manifestations of alcohol withdrawal syndrome, it comes later on, after other minor alcohol withdrawal symptoms have begun. Usually, delirium tremens occurs about three days into the withdrawal process, however it can occur as late as a week to 10 days after quitting the use of alcohol.
DTs will typically last two to three days, but can last up to eight days. These days can be extremely distressing and tormenting, and the individual should be provided professional medical care throughout the entirety of this period. The distress of this condition comes with several symptoms, including hyperthermia, tachycardia, diaphoresis, mental confusion, disorientation, and psychosis. Individuals with heavy, long-term alcohol use are at risk of experiencing the symptoms of delirium tremens. Symptoms can further include daylong slumber, irritability, quick mood changes, agitation, and heightened sensitivity to sound, touch, and light. Grand mal seizures and convulsions of the entire body can also occur within the first 12 to 48 hours.
Due to the great number of delirium tremens symptoms and their quick occurrence, the condition is regarded as a medical emergency. In fact, about 40% of individuals who suffer from delirium tremens die because of the condition. Therefore, the condition has a high fatality rate, and requires prompt medical attention as soon as DTs symptoms are noted.
DT often trigger medical complications, which account for the high fatality rate. Complications can include heart rhythm abnormalities, seizure-related complications, very high body temperature, high blood pressure, and high heart rate. The complications allow the symptoms to progress rapidly and become increasingly severe despite the efforts of medical treatment.
Even though delirium tremens is not a permanent condition, it has the potential to be fatal without prompt medical attention and treatment. Individuals embarking on an alcoholism treatment process, and those assisting loved ones, should incorporate medical professionals in treatment centers into this process to mitigate the risks of potentially fatal withdrawal symptoms.
Causes and Risk Factors of DT
It is not possible to determine who will develop delirium tremens with absolute certainty, and so precautions should be taken for all undergoing addiction treatment. Development varies based on frequency of alcohol use and the level of dependency. Those with a history of heavy and frequent use are more likely to develop DTs in the treatment process.
Starting alcohol use can already cause significant changes in the nervous system, followed by the slowdown of brain functioning. That is a sensation that causes sedation and decreased anxiety. Continuous alcohol use can force the brain to adjust and compensate, which results in a craving for more alcohol. This phenomenon that happens with regular alcohol use is referred to as tolerance.
Once the brain continues to adapt to alcohol use, dependency follows. That drives the brain to still produce excitatory signals even with a sudden stop of alcohol use or significantly reduced use, which then leads to withdrawal symptoms. Moreover, individuals with heavy, long-term alcohol use have a higher chance of developing the most severe manifestations of alcohol withdrawal, including delirium tremens.
Those most at risk are those who consume seven or eight pints of beer or a pint of hard liquor per day, or those who drink about two to three bottles of wine daily. Individuals who have previously suffered from the condition are more susceptible to developing it again.
Close monitoring and the right treatment program are needed to care for patients undergoing withdrawal, especially for those with significant risk factors. Additional risk factors include structural brain lesions, autonomic nervous system overactivity, lower blood platelet counts, and low potassium levels. Delirium tremens has a myriad of risk factors associated with its development, and should be a serious consideration when planning your treatment journey.
Treatment for DT
Due to the high fatality rate and risk of medical complications, delirium tremens is regarded as a medical emergency—best to be treated in an ICU or an inpatient ward. Usually, the treatment focuses on mitigating risks of complications such as controlling agitation, decreasing seizure risk, and promoting quality sleep.
Patients with delirium tremens are generally treated in a quiet, well-lit room wherein their vital signs, hydration status, and electrolyte levels are constantly monitored. Patients are continuously visited due to the possibility of mental confusion, hallucinations or diverging from reality. Hence, they require regular reminders of what’s happening to them and where they are.
Moreover, individuals that suffer from this alcohol withdrawal syndrome also receive medications and therapy. Aside from treating the condition itself, the treatment for delirium tremens is also focused on the prevention of other syndromes and medical complications, such as Wernicke-Korsakoff syndrome, a fatal brain disorder. The treatment also uses intravenous sedatives to keep patients calm and prevent seizures.
Even though there are common grounds for the treatment of delirium tremens, it still varies on a case-to-case basis. In fact, some patients may be required to take antipsychotic medications as part of the treatment in order to avoid hallucinations and severe agitation. Not all individuals who drink alcohol will develop delirium tremens, and for those who have it, the condition will require immediate medical intervention. With all the possible treatments for delirium tremens and other alcohol withdrawal symptoms, patient comfort and safety must always be the top priority.
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Frequently Asked Questions
This FAQs section provides more relevant information about delirium tremens. Learn more here:
Why is it important to treat delirium tremens?
Delirium tremens is among the most severe manifestations of alcohol, which makes it life-threatening to neglect it.
Can delirium tremens cause anxiety?
Along with the physical symptoms of uncontrollable tremors, fever, and more, delirium tremens can also cause extreme anxiety. Patients may become confused, paranoid, and even think they will die, despite getting treated. That’s why part of delirium tremens includes medication to offset anxiety and other symptoms.
Does delirium tremens get worse at night?
Symptoms of delirium tremens can cause disturbance in everyday life. But the symptoms often worsen at night. While the condition rarely persists for a long time, several symptoms suggest that it is a medical emergency requiring prompt medical attention.
What can worsen delirium tremens outcomes?
Delirium tremens can become worse if alcohol use is combined with drug use. Also, later treatment increases the chance of this condition becoming fatal.
How should patients with delirium tremens be treated?
Since delirium tremens treatment is best carried out in ICU or an inpatient ward, interventions for patients with delirium tremens include comprehensive and regular assistance and medical attention.
Interventions include the following:
– Assess the level of anxiety
– Reassuring patients and keeping them calm
– Provide an appropriate healing environment to eliminate the danger