DTs; Alcohol withdrawal - delirium tremens; Alcohol withdrawal delirium
Delirium tremens is a severe form of alcohol withdrawal. It involves sudden and severe mental or nervous system changes.
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 is most common in people who have a history of alcohol withdrawal. It is especially common in those who drink 4 to 5 pints (1.8 to 2.3 liters) of wine, 7 to 8 pints (3.5 to 4 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 most often occur within 48 to 96 hours after the last drink. But, they can occur 7 to 10 days after the last drink.
Symptoms may get worse quickly, and can include:
Seizures (may occur without other symptoms of DTs):
Symptoms of alcohol withdrawal, including:
Other symptoms that may occur:
Delirium tremens is a medical emergency.
The health care provider will perform a physical exam. Signs may include:
The following tests may be done:
The goals of treatment are to:
A hospital stay is needed. The health care team will regularly check:
While in the hospital, the person will receive medicines to:
Long-term preventive treatment should begin after the patient recovers from DT symptoms. This may involve:
Treatment may be needed for other medical problems that can occur with alcohol use, including:
Attending a support group regularly is a key to recovering from alcohol use.
Delirium tremens is serious and may be life-threatening. Some symptoms related to alcohol withdrawal may last for a year or more, including:
Complications can include:
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms. Delirium tremens is an emergency condition.
Avoid or reduce the use of alcohol. Get prompt medical treatment for symptoms of alcohol withdrawal.
Ferri, FF. Delirium tremens. In: Ferri FF, ed. Ferri's Clinical Advisor 2015. 1st ed. Philadelphia: PA Elsevier Mosby; 2015:p. 357.
O'Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 33.
Last reviewed on: 2/8/2015
Reviewed by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.