Published: 18 Jun 2025

ICD9: 291.0      ICD10: F10.231      ICD11: 6C40.5

Delirium tremens (DTs) is a severe form of alcohol withdrawal that involves sudden and severe mental or nervous system changes.
It's a serious and potentially life-threatening condition that requires immediate medical attention.

Here's a breakdown:

Alcohol Withdrawal: When someone who is physically dependent on alcohol suddenly stops drinking or significantly reduces their intake, they can experience a range of withdrawal symptoms. These symptoms can vary in severity, from mild anxiety and tremors to severe complications like DTs.

Delirium Tremens (DTs): DTs is the most severe form of alcohol withdrawal. It's characterized by:
Delirium: A state of confusion, disorientation, and impaired awareness of the surroundings. People with delirium may not know where they are, who they are, or what time it is. They may have difficulty thinking clearly and paying attention.
Tremors: Uncontrollable shaking, particularly in the hands.
Hallucinations: Seeing, hearing, or feeling things that aren't there. These can be visual, auditory, or tactile.
Autonomic Instability: Problems with the body's automatic functions, such as:
Rapid heart rate (tachycardia)
High blood pressure (hypertension)
Sweating (diaphoresis)
Fever
Seizures: In some cases, DTs can lead to seizures.

Causes:

DTs is caused by the brain's adaptation to chronic alcohol use. Alcohol depresses the central nervous system. When someone drinks heavily for a prolonged period, the brain adjusts to this constant depression. When alcohol is suddenly withdrawn, the brain becomes overexcited, leading to the symptoms of DTs.

Risk Factors:

History of chronic alcohol abuse
Previous episodes of alcohol withdrawal, especially DTs
Underlying medical conditions
Head injury
Liver disease

Symptoms:

Symptoms of DTs usually start within 48 to 96 hours after the last drink, but they can sometimes occur later. Symptoms can include:

Agitation
Anxiety
Confusion
Delirium
Disorientation
Hallucinations
Fever
Rapid heart rate
High blood pressure
Heavy sweating
Seizures
Tremors

Diagnosis:

DTs is diagnosed based on a person's symptoms, medical history, and physical examination. Doctors may also use blood tests to check for other medical conditions that could be contributing to the symptoms.

Treatment:

DTs is a medical emergency that requires immediate treatment in a hospital setting. Treatment typically includes:

Medications:
Benzodiazepines: To help calm the nervous system and reduce anxiety, agitation, and the risk of seizures.
Antipsychotics: To manage hallucinations and delusions.
Other medications: To address specific symptoms like high blood pressure or rapid heart rate.
Supportive Care:
Intravenous fluids: To prevent dehydration.
Nutritional support: To address any nutritional deficiencies.
Monitoring: Close monitoring of vital signs (heart rate, blood pressure, temperature) to ensure stability.

Complications:

DTs can lead to serious complications, including:

Seizures
Cardiac arrhythmias
Aspiration pneumonia
Dehydration
Electrolyte imbalances
Brain damage
Death

Prevention:

The best way to prevent DTs is to avoid alcohol abuse. People who are dependent on alcohol should seek medical help to safely withdraw from alcohol under medical supervision.

In Summary:

Delirium tremens is a dangerous condition that can occur during alcohol withdrawal. It's crucial to recognize the symptoms and seek immediate medical attention. With prompt treatment, most people recover from DTs.

Disclaimer: This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. If you suspect someone is experiencing DTs, seek immediate medical attention by calling emergency services (911 in the US) or going to the nearest emergency room.