Delirium Tremens

What Is Delirium Tremens?

A well-documented phenomenon for which there is a medical history dating back over 200 years, Delirium Tremens (DT) is a term that is used to refer to the most severe form of alcohol withdrawal. Also called alcohol withdrawal delirium, DT is not to be taken lightly by those suffering from an alcohol use disorder. The condition can be deadly. If you notice the signs of DT in yourself or in a loved one, stop reading and call 911 immediately.

What Are The Signs?

Symptoms of DT have been known to appear after an individual has spent roughly 48 hours withdrawing from alcohol. Signs that someone is currently going through alcohol withdrawal include:

• Tremors in the extremities
• Nervousness, from mild stress all the way up to panic attacks
• Gastrointestinal upset
• Sleeplessness
• Dizziness
• Excessive perspiration

Presence of the above symptoms may indicate alcohol withdrawal, which could lead to DT if it’s a particularly serious case where extremely heavy amounts of alcohol have been consumed over a prolonged period of time. The symptoms of DT include:

• Profound confusion
• Hallucinations
• The feeling of bugs crawling in or around the skin
• Delusions somewhat similar to schizophrenia
• Autonomic hyperactivity (an over-excitement of the nervous system that may result in sweating, a fast heartbeat, or an extreme change in body temperature)
• Cardiovascular collapse, which leads to unconsciousness and eventually death

After onset, DT can last as long as 5 days. These symptoms constitute a medical emergency, as DT becomes fatal in more than a third of its cases. If someone going through withdrawal begins presenting with the above symptoms, they need to see a medical professional immediately.

Who Is At Risk?

One must be going through alcohol withdrawal in order to experience DT. Fortunately, the condition is extremely rare, occurring at most in 3-5% of individuals who abuse alcohol. With that in mind, some of the risk factors that increase the chances one will be afflicted with DT are below.

• Someone who has experienced DT before is more likely to go through DT again in the future.
• Individuals who have previously had a seizure may be more at risk for DT.
• Those who have already gone through alcohol withdrawal once before are more prone to DT.
• People suffering from an electrolyte imbalance are more susceptible to DT.
• Those with simultaneously-occurring diseases or infections may be more at risk for DT.
• Individuals who have recently suffered a head injury could be more at risk for DT.
• DT tends to be observed more commonly in adult men, especially those who are white, younger, and either single or divorced.

What’s Happening In The Brain of Someone With Delirium Tremens?

When someone drinks alcohol, especially for a long time, it begins to heavily interfere with crucial communications happening in the brain. One way alcohol disrupts brain activity is by interacting with an amino acid called Gamma aminobutyric acid, or GABA. GABA is a very important neurotransmitter because it helps calm the nervous system, helping to prevent seizures and contribute to a sense of rest and relaxation in the body.

Ironically, many people drink precisely because they want to receive the feelings of calm and serenity that GABA provides. But the introduction of alcohol to the delicately fine-tuned systems of the brain actually results in GABA activity being greatly reduced in the long run. This leaves someone prone to stress, panic, excitability, seizure, and even death.

Treatment For Delirium Tremens

If someone with DT makes it to the hospital in an appropriate amount of time, they may be treated with a variety of different medications in an attempt to stabilize their condition. Those medications are listed and described below.

• Benzodiazepines. Also known as “benzos,” Benzodiazepines function to counteract the damage alcohol has had on the brain by increasing levels of GABA. This means that the medication has an extremely calming and sedative effect, and may be given to someone experiencing autonomic hyperactivity, a symptom of DT. Common medicines in this class include diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), and chlordiazepoxide (Librium). By slowing down the central nervous system, chlordiazepoxide can help save the life of someone threatened by the worst of DT’s symptoms.
• Levetiracetam (Keppra). An anti-seizure medicine, Keppra is an anticonvulsant or anti-epileptic medication. It may work to counteract the seizures caused by the throes of DT in someone afflicted by the condition.
• Antipsychotic drugs, such as Haloperidol, may also be prescribed in order to treat the hallucinations and delusions that can accompany DT. An attempt to combat hallucinations is also why it’s crucial and common that DT patients are treated in an extremely welcoming and well-lit room.
• Vitamins like Thiamine, which is commonly deficient in those who struggle with alcohol addiction, may also be given to the patient.

Controversially, alcohol has previously been prescribed to patients going through withdrawal as a last-ditch means of saving their life. The use of alcohol to prevent or treat alcohol withdrawal or DT is not recommended.

Detoxing From Alcohol Safely

The risks of DT, while the condition is statically rare, can be life-threatening. What starts as relatively minor sweating and shaking, symptoms many who struggle with addiction may have experienced before, can rapidly progress to intense seizures and hallucinations.

That’s why it’s so important to detox from alcohol in a safe environment. If you or a loved one are struggling with alcohol use disorder and looking for a rehab, contact a treatment provider today.