Delirium tremens

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DT's; Alcohol withdrawal - delirium tremens

Symptoms most commonly occur within 72 hours after the last drink, but may occur up to 7 - 10 days after the last drink. Symptoms may get worse rapidly, and can include:

• Body tremors
• Mental status changes
  • Agitation, irritability
  • Confusion, disorientation
  • Decreased attention span
  • Decreased mental status
    • Deep sleep that persists for a day or longer
    • Stupor, sleepiness, lethargy
    • Usually occurs after acute symptoms
  • Delirium (severe, acute loss of mental functions)
  • Excitement
  • Fear
  • Hallucinations (such as seeing or feeling things that are not present are most common)
  • Highly sensitive to light, sound, touch
  • Increased activity
  • Mood changes rapidly
  • Restlessness, excitement
• Seizures
  • Most common in first 24 - 48 hours after last drink
  • Most common in people with previous complications from alcohol withdrawal
  • Usually generalized tonic-clonic seizures
• Symptoms of alcohol withdrawal
  • Anxiety
  • Depression
  • Difficulty thinking clearly
  • Fatigue
  • Feeling jumpy or nervous
  • Feeling shaky
  • Headache, general, pulsating
  • Insomnia (difficulty falling and staying asleep)
  • Irritability or easily excited
  • Loss of appetite
  • Nausea
  • Pale skin
  • Palpitations (sensation of feeling the heart beat)
  • Rapid emotional changes
  • Sweating, especially the palms of the hands or the face
  • Vomiting

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Additional symptoms that may occur:

• Chest pain
• Fever
• Stomach pain

Delirium tremens is a medical emergency.

The health care provider will perform a physical exam. Signs may include:

• Heavy sweating
• Increased startle reflex
• Irregular heartbeat
• Problems with eye muscle movement
• Rapid heart rate
• Rapid muscle tremors

The following tests may be done:

• Chem-20
• Electrocardiogram (ECG)
• Electroencephalogram (EEG)
• Toxicology screen

Review Date: 03/03/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).