The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Delirium Tremens — Severe Alcohol Withdrawal

Severe alcohol withdrawal syndrome with autonomic instability, hallucinations and confusion.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Delirium Tremens — Severe Alcohol Withdrawal?

Delirium tremens is the most severe form of alcohol withdrawal that develops in chronic heavy alcohol users when they stop drinking.

It is characterised by tremor, sweating, tachycardia, hypertension, fever, hallucinations and disorientation.

Without treatment, mortality is 15-20%; with intensive medical management it falls to 1-5%; intensive care monitoring and benzodiazepine titration are essential.

Symptoms

Severe coarse tremor (especially in hands)
Confusion and disorientation in time-place
Visual hallucinations (insects, animals)
Tachycardia (>100/min) and hypertension
Sweating, fever (>38°C) and dehydration
Generalised seizures (10-30%)
Anxiety, agitation and combative behaviour

Risk Factors

Chronic heavy alcohol use (>10 drinks/day, >10 years)
Previous history of alcohol withdrawal seizure or DT
Comorbid medical illness (infection, head trauma)
Old age and electrolyte disturbance
Concomitant benzodiazepine or opioid dependence
Hepatic encephalopathy and chronic liver disease
Comorbid psychiatric disorder

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Emergency presentation by 112 ambulance is mandatory in alcohol withdrawal: tremor, confusion and hallucinations
  • Intensive care monitoring is required and CIWA-Ar scale is followed
  • Mortality risk is high; thiamine supplementation prevents Wernicke encephalopathy
  • Long-term alcohol-use disorder treatment is essential

Treatment Methods

01
High-dose intravenous benzodiazepine (diazepam, lorazepam)
02
CIWA-Ar scale-guided dose titration
03
Thiamine 100-500 mg IV (before glucose)
04
Aggressive intravenous fluid and electrolyte replacement (Mg, K)
05
Phenobarbital or propofol (refractory cases)
06
Long-term naltrexone, acamprosate and AA support

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Acil Servis Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Heart Attack First Aid

Acil Servis

Quick recognition and an emergency call in a heart attack dramatically improve the chance of survival.

Stroke Symptoms and FAST Test

Acil Servis

The FAST (Face, Arms, Speech, Time) test is the most practical method for early detection of stroke.

Anaphylaxis (Anaphylactic Shock)

Acil Servis

Anaphylaxis is a severe systemic allergic reaction; epinephrine injection and 112 are the most critical initial interventions.

Respiratory Failure

Acil Servis

Respiratory failure is a life-threatening state characterized by low blood oxygen or rising carbon dioxide.

Poisoning First Aid

Acil Servis

In poisoning, identifying the correct substance and knowing when not to induce vomiting is critical.

Burn Treatment and First Aid

Acil Servis

Emergency treatment for burns varies by degree and extent, starting with cooling and extending to specialist care.

Head Trauma First Aid

Acil Servis

Regardless of the impact severity in head trauma, emergency neurological evaluation is mandatory if there is any change in consciousness.

Emergency Assessment of Chest Pain

Acil Servis

In a patient with chest pain, ECG and cardiac biomarkers rapidly help to distinguish heart attack and pulmonary embolism from other causes.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.