Delirium tremens

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DT's; Alcohol withdrawal - delirium tremens

The goals of treatment are to:

• Save the person's life
• Relieve symptoms
• Prevent complications

A hospital stay is required. The health care team will regularly check:

• Blood chemistry results, such as electrolyte levels
• Body fluid levels
• Vital signs (temperature, pulse, rate of breathing, blood pressure)

Symptoms such as seizures and heart arrhythmias are treated with the following medications:

• Anticonvulsants such as phenytoin or phenobarbital
• Central nervous system depressants such as diazepam
• Clonidine to reduce cardiovascular symptoms and reduce anxiety
• Sedatives

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The patient may need to be put into a sedated state for a week or more until withdrawal is complete. Benzodiazepine medications such as diazepam or lorazepam are often used. These drugs also help treat seizures, anxiety, and tremors.

Antipsychotic medications such as haloperidol may sometimes be necessary for persons with hallucinations.

Long-term preventive treatment should begin after the patient recovers from acute symptoms. This may involve a "drying out" period, in which no alcohol is allowed. Total and lifelong abstinence is recommended for most people who go through withdrawal. The person should receive treatment for alcohol use or alcoholism, including:

• Counseling
• Support groups (such as Alcoholics Anonymous)

The patient should be tested, and if necessary, treated for other medical problems associated with alcohol use. Such problems may include:

• Alcoholic cardiomyopathy
• Alcoholic liver disease
• Alcoholic neuropathy
• Blood clotting disorders
• Wernicke-Korsakoff syndrome

For additional resources, see alcoholism support group.

Delirium tremens is serious and may be life threatening. Symptoms such as sleeplessness, feeling tired, and emotional instability may persist for a year or more.

• Heart arrhythmias, may be life threatening
• Injury from falls during seizures
• Injury to self or others caused by mental state (confusion/delirium)
• Seizures

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms. Delirium tremens is an emergency condition.

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).