What is delirium tremens?

Delirium tremens (the DTs) is a disorder that occurs in a small percentage of alcoholics and is caused by the body's reaction to not having alcohol. It is a serious medical disorder that includes extreme confusion, agitation, hallucinations, and other symptoms of severe alcohol withdrawal. Delirium tremens usually starts 24 to 72 hours after a chronic alcoholic either stops or severely limits his or her drinking of alcohol. Delirium tremens is potentially fatal.

How does it occur?

Chronic drinking changes the biochemical functioning of the body and brain. When you start drinking 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

• panic attacks

• restlessness and inability to sleep

• delusions (believing things that are not true)

• hallucinations (hearing or seeing things that are not there)

• disturbed behavior

• major memory disturbances

• dizziness

• rapid heartbeat

• fever

• dilated pupils

• convulsions

• 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 experience symptoms of the DTs, someone should take you to the emergency room at a hospital.

In the hospital, you will be closely watched and restrained if necessary to prevent injury to yourself and others. The doctor will monitor your blood pressure, pulse, and breathing. You will be given a nutritious diet and intravenous (IV) fluid supplements. You may receive vitamin supplements as well.

You will stay in a well-lighted room. A staff member will come in to talk with you and check on you several times a day. Family support will be welcomed. The staff will monitor your anxiety, delusions, and hallucinations, and help you through these events.

The doctor may prescribe sedatives and other medications to keep you calm and prevent seizures. The doctor will gradually reduce your dosage as your withdrawal ends.

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?

Coming to terms with alcohol dependence before it becomes a chronic, life-threatening problem is the best prevention.

Alcoholism is a treatable problem. If treated in its early stage by abstinence from alcohol you can avoid medical complications such as the DTs.

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. Look up the phone number in the business section of your phone book to get more information on AA (for alcoholics) or Al-Anon (for families of alcoholics).