delirium tremens

Delirium Tremens

Updated 17/03/20

Delirium tremens symptoms usually develop 2-3 days into the onset of alcohol withdrawal. Delirium tremens is a symptom of alcohol withdrawal where there is a physical dependence on alcohol, i.e. alcoholism. You may be familiar with the terms’ DT’s’ or ‘The Shakes’ but wonder what are DT’s?

Rehab Guide specialises in the professional treatment of drug and alcohol addiction. Here, we take an in-depth look at how the symptoms of delirium tremens manifest, who suffers from them, how to avoid them, and the associated risks and dangers.

Delirium tremens is one of the more severe alcohol withdrawal symptoms that can result from alcohol dependency. It is important to know what they are and what to do if you or someone you know suffers from them.

What is delirium tremens?

Delirium tremens, DT’s usually result from the onset of alcohol withdrawal in an individual that suffers from a heavy alcohol dependency of a month or more (1) A similar condition is also associated with benzodiazepine withdrawal and barbiturate withdrawal.

Developing delirium tremens is a sign that the body and brain are not coping with the detoxification process, or that the brain is chemically imbalanced through not having enough alcohol in the system.

Alcohol is actually one of the most, if not THE most dangerous substances to withdraw from. Not many people realise this. Most people see drinking alcohol as a harmless way of letting their hair down or relaxing after a busy day, but for those that suffer from alcoholism, alcohol is anything but harmless!

What are delirium symptoms

The symptoms can range from mild to severe and last for up to 3 days on average. In the most severe cases of delirium tremens, the sufferer can actually die if they are not urgently medically treated. (2)

What does delirium tremens feel like?

  • Rapid onset of confusion – the sufferer may be confused by what is happening to them, unable to answer simple questions, suffer from disorientation, detachment from reality and be unable to relate to time and location.
  • Shaking – Uncontrollable shaking that is especially evident in the hands
  • Sweating – Resulting from the body not being able to regulate temperature, hot and cold flashes, fever, and the body trying to expel alcohol quicker through sweat.
  • Shivering – Unable to self-regulate body temperature and development of a fever
  • Irregular heart rate – Heart rate may race uncontrollably, palpitations or skip beats
  • Hallucinations – Seeing and/or hearing things that are not there. Naturally, this will add to the symptoms of confusion.
  • Very high body temperature and seizures – alcoholic seizures are extremely dangerous and can result in death (2)

Any person that develops the symptoms of delirium tremens must seek URGENT medical attention at their local hospital in order to avoid coma and death.

Causes of delirium tremens

Delirium tremens symptoms, DT’s is the most severe form of alcohol withdrawal and only develops in those with chronic alcohol dependence.

Drinking alcohol frequently and in excessive amounts for a prolonged period of time affects how the brain’s neurotransmitter systems operate. The brain develops new pathways and chemically alters in order to function alongside regular intoxication. As a result, the brain becomes alcohol dependent.

Removing alcohol abruptly or too quickly from an alcohol-dependent drinker results in the brain being unable to function properly. This causes a number of alcohol withdrawal symptoms to manifest. Extreme drinking excites and irritates the nervous system. If you drink every day, your body becomes reliant on alcohol over time. When this happens, your central nervous system can no longer adjust easily to the lack of alcohol. The more severe the alcohol abuse, the more likely severe symptoms such as DT’s are to take hold (3)

In cases of minor alcohol withdrawal or where an alcohol detox is controlled, less severe symptoms such as anxiety, nausea, insomnia, sweating and tremor occur. Major or acute alcohol withdrawal symptoms include more dangerous and life-threatening symptoms such as visual and/or auditory hallucinations, excessive sweating and dehydration, whole-body tremor, high blood pressure, high body temperature, fast and erratic heartbeat, psychosis, seizures and delirium tremens. (3)

Delirium tremens can also occur in chronic alcohol-dependent drinkers where the individual has not consumed the required levels of alcohol that their brain has become accustomed to in order to function.

Who is at risk of DT’s/ Delirium tremens?

Anyone who is physically addicted to alcohol is at risk of developing DT’s. This is especially true of those that suffer from chronic alcoholism. Whilst delirium tremens are quite rare. Still, an estimated 10-15 % of alcoholics will experience them at some point during their drinking days (4)

If you or someone you know suffers from alcohol addiction/dependence and want to stop drinking, it is vital that you do not attempt to do so without first seeking professional help and advice. The more severe and dangerous symptoms of alcohol withdrawal syndrome can cause death.

Attempting to go ‘cold turkey’ from alcohol addiction and stopping abruptly without medical intervention can be catastrophic; this is where we would strongly recommend a medical alcohol detox in order to safeguard your wellbeing.

Individuals in poor physical health, who are also physically addicted to drugs, and those who have a history of seizures are also more prone to developing the DT’s during alcohol withdrawal. The longer you have been physically dependent on alcohol, the greater the risks are of complications during detox.

Spotting the DT’s in a loved one or family member

Spotting the symptoms of DT’s in someone you care for could just save their life, providing you take the appropriate action quickly.

Probably the most common symptom of delirium tremens is what is commonly referred to as the “Shakes”. The person suffering will have a tremor that they cannot control. The tremor /shakes may be so bad in their extremities {(hands and legs) that they cannot walk or hold a cup. They may also appear to tremble as they talk and have a jittery tone to their voice.

When alcohol-related tremors are severe or accompanied by confusion, disorientation, convulsions or hallucinations, emergency medical treatment is required IMMEDIATELY, drinking more alcohol may temporarily help to alleviate the symptoms, but this method is not guaranteed. Anyone one of these symptoms can become life-threatening if not immediately and appropriately seen by a doctor.

If your loved one or family member is drinking daily and heavily or have previously displayed any signs of alcohol withdrawal, they will need professional medical help in order to stop drinking alcohol safely.

For immediate alcohol rehab contact Rehab Guide on 0207 2052 845 and speak with one of our addiction experts, who will assess and advise on the appropriate course of the treatment plan for your individual set of circumstances.

The dangers and risks associated with delirium tremens

The biggest danger and risk associated with developing delirium tremens is death. Delirium tremens carries a 15% mortality rate with treatment and up to 35% mortality rate without treatment, a significant percentage we are sure you will agree. (4)

Developing DT’s is most common in alcoholics who have undergone detox previously and started drinking again. The more detoxes a person undergoes, the higher the risk they have of developing life-threatening complications such as delirium tremens.

Experiencing repeated delirium tremens and seizures can also lead to alcohol-related brain damage, alcoholic delirium psychosis and the onset of Wernicke-Korsakoff syndrome.

How to avoid delirium tremens and treatment for DT’s

The most effective way of preventing the onset of delirium tremens is to keep your drinking within the Chief Medical Officers Safe Drinking Guidelines. If you do have a dependence on alcohol, then it is vital that you do not quit drinking suddenly.

Delirium tremens treatment and delirium tremens medication can be with the use of pharmacological medications, in particular benzodiazepines. Benzodiazepines help to relax the body and brain during detox and have a sedative effect that combat the effects of alcohol withdrawal symptoms.

Medical alcohol detoxes should only be conducted by qualified medical professionals within a clinical environment. A standard alcohol detox programme in an alcohol detox clinic is managed over a 7-10 day period. We do not recommend attempting this by yourself at home. Even with the assistance of medication, there are numerous risks and complications that can arise if not fully medically supervised.

Rehab Guide provide safe and effective medical detoxes for alcohol within our CQC registered detox clinics and rehab centres. All medical alcohol detoxes are carried out by our qualified doctors, nurses and highly skilled therapists. We provide medical and therapeutic care around the clock to ensure that each patient’s detox is as safe and as comfortable as possible, with minimal risk to their health.

Treatment For Alcohol Abuse And Addiction

If you or a loved one develop symptoms of delirium tremens, this should be considered a medical emergency. Please contact you local emergency services immediately! Delaying or not seeking a treatment plan for the DT’s can ultimately result in long term damage or death.

If you wish to stop drinking alcohol but cannot afford an inpatient alcohol detox, please contact your local drug and alcohol services and your GP. You should only attempt to stop alcohol with their professional assistance and guidance.

If you have any questions about rehab costs, alcohol detox or alcohol rehab programmes, call Rehab Guide today; alcohol rehab may well be more affordable than you think.

Undergoing a professional medical detox for alcohol addiction is clinically proven to be the most effective and safest way of quitting alcohol.

Call us now on 0207 2052 845 and speak with one of our alcohol treatment experts.

 

Sources and references:

 

  1. Primary Care Companion to the Journal of Clinical Psychiatry. doi:10.4088/PCC.10r00991ecr. PMC 2947546. PMID 20944765.
  2. Recognition and management of withdrawal delirium (delirium tremens)”. The New England Journal of Medicine. 371 (22): 2109–13.
  3. https://emedicine.medscape.com/article/166032-overview.
  4. NICE Clinical Guidelines, No. 100. National Clinical Guideline Centre (UK).

5.London: Royal College of Physicians (UK); 2010. – Clinical management of alcohol- related physical complications. https://www.ncbi.nlm.nih.gov/books/NBK65581/

& Delirium Tremens (DTs): Prognosis eMedicine

 

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