Delirium Tremens

What is delirium tremens?

Delirium tremens (the DTs) is a severe reaction to withdrawal from alcohol. Delirium tremens can be deadly. The DTs usually start 24 to 72 hours after a chronic alcoholic either stops or limits drinking.

How does it occur?

Chronic drinking changes the way the body and brain work. When you drink less or completely stop drinking, your body and brain chemistry change again. While you are going through these changes, you suffer severe reactions.

What are the symptoms?

Symptoms of the DTs include:

• nightmares (accompanied by the sense of not being able to breathe)
• anxiety or panic attacks
• tremors or shakes
• restlessness and inability to sleep
• delusions (believing things that are not true)
• hallucinations (hearing or seeing things that are not there)
• disturbed behavior
• confusion and disorientation
• dizziness
• rapid heartbeat
• fever
• dilated pupils
• seizures
• sweating.

How is it diagnosed?

Delirium tremens is a medical emergency. A doctor will take your medical history, including your history of alcohol use. He or she will give you a physical exam and may order blood tests and X-rays. Be as honest as you can about your drinking. Without accurate information your doctor cannot help you.

How is it treated?

Do not try to withdraw from heavy, prolonged use of alcohol without help. If you have symptoms of the DTs, someone should take you to the emergency room at a hospital.

In the hospital, you will be closely watched and sedated if necessary to prevent injury to yourself and others. Your blood pressure, pulse, and breathing will be checked often. You will be given a special diet and intravenous (IV) fluid supplements. The doctor may prescribe medicines to keep you calm and prevent seizures. You may receive vitamin supplements as well.

How long will the effects last?

The symptoms of delirium tremens usually last 1 to 5 days. However, they can last for as long as 10 days.

How can I take care of myself?

You can help take care of yourself by following these guidelines:

• If you are in the hospital, keep the caregivers informed about how you are feeling. Report any auditory (voices) or visual (small bugs, animals) hallucinations.
• Rest.
• Eat and drink healthy foods and fluids as much as possible.
• Abstain from alcohol as recommended by your doctor.
• Do not drink alcohol while you are taking drugs to aid your withdrawal.
• Follow your doctor's advice for treatment of any other medical problems.

How can I stop the effects of alcohol dependence?

To keep from having DTs, do not abuse alcohol. If you do drink large amounts for a long time, do not suddenly decrease the amount or stop drinking on your own. Talk with your healthcare provider about a safe way to stop abusing alcohol.

If you are hospitalized for a reason other than alcoholism and you are a chronic drinker, inform your doctor and caregivers so they can prepare to treat delirium tremens. If you keep this information from your doctor, you may have serious complications that could result in death.

Alcoholics Anonymous (AA) meetings are open to all at no cost. In many cities there are several meetings every day at various locations to fit your schedule. You can look up the phone number for a local chapter of AA (for alcoholics) or Al-Anon (for families of alcoholics) in the business section of your phone book.

For more information, see Resource List: Alcohol Abuse.