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Delirium Tremens: Symptoms, Timeline, and Treatment


Author: Thomas Roth

Last Updated: 3/25/2022

Delirium tremens occurs when someone stops consuming alcohol. It doesn’t happen to everyone but people with severe cases of alcohol withdrawal can experience this condition. The condition is caused by sudden changes to the nervous system that result in hallucinations, seizures, and other mental health disorders. Delirium tremens is more likely to develop in people who consume more than 4 pints per day over the course of 10 years. Therefore, they’re a sign of heavy drinking and alcohol abuse.

What Are Delirium Tremens?

Delirium tremens is a severe symptom of alcohol withdrawal and only occurs in serious cases. The condition causes shaking, hallucinations, paranoia, and other mental health conditions. It’s caused by sudden changes to the nervous system that occurs when a heavy alcoholic stops consuming alcohol for a few days. In most cases, delirium tremens begin within 3-5 days of no alcohol consumption. When symptoms occur people need to seek medical supervision to prevent death and other complications.

What are the Causes and Risk Factors of Delirium Tremens?

Delirium tremens is caused by alcohol withdrawal. While it’s a rare condition, risk factors for delirium tremens include drinking more than 4 pints of alcohol daily and a long history of alcohol abuse. When alcohol is consumed in these large quantities the body adapts by making changes to the nervous system. If someone stops drinking at this point, sudden changes can cause their body to have nervous system problems and other brain issues.

How Much Alcohol Causes Delirium Tremens?

Delirium tremens is caused by decades of frequent alcohol consumption. People that develop delirium tremens typically have a long history of alcohol abuse (10-20 years) and consume large amounts of alcohol daily. Therefore, about 5-10 standard drinks per day over the course of a few decades cause delirium tremens. Still, it’s a rare condition that only happens to some people.

What Stage of Alcohol Withdrawal does Delirium Tremens Occur at?

According to the American Academy of Family Physicians, there are three stages of alcohol withdrawal. Alcoholics may experience mild symptoms during the first stage but as time goes on symptoms become more severe. Symptoms for the first stage of alcohol withdrawal include anxiety, stomach issues, and some mental health problems including insomnia. The second stage of alcohol withdrawal includes elevated heart rate, blood pressure, changes in breathing, and even confusion. Lastly, the third stage of alcohol withdrawal is when delirium tremens and other dangerous symptoms occur. This stage includes the same problems as the first two stages but with hallucinations, tremors, reduced attention, and even seizures.

What are the Symptoms of Delirium Tremens?

Delirium tremens have different symptoms depending on the severity of the condition. That said, some common symptoms occur in most cases of delirium tremens. These symptoms are listed below.

  • Restlessness
  • Sweating
  • Fever
  • Delirium
  • Hallucinations
  • Rapid heart rate
  • Anxiety
  • Tremors
  • Insomnia
  • Seizures
  • Shallow breathing

These are only a handful of the symptoms that can occur. Symptoms of delirium tremens are severe, so it’s important to seek medical attention.

How Common is Delirium Tremens?

Delirium tremens is a rare condition. While people who abuse alcohol for many years have a higher risk of developing the condition, it can occur in anyone who is dealing with alcohol withdrawal. Some of the statistics about delirium tremens are listed below.

  • About 14 million people are diagnosed with alcoholism each year
  • 50% of people who are diagnosed with alcoholism suffer from withdrawal
  • Only 3-5% of alcoholism cases lead to delirium tremens during withdrawal
  • Delirium tremens has a mortality rate close to 40% for people who don’t seek medical attention

Based on these statistics, it’s clear that delirium tremens is a rare condition but a dangerous one.

How to Diagnose Delirium Tremens?

Delirium tremens need to be diagnosed by a medical professional. To diagnose the condition, medical professionals perform a series of tests and evaluate a patient’s symptoms. Doctors look for agitation, hallucinations, tremors in the hands, and sweating. These tests are typically performed on individuals who are detoxing from alcohol. Moreover, delirium tremens only occur in 1% or 2% of alcohol withdrawal cases, so only some patients are monitored. Some tests with MRI and CT machines may also be used to differentiate between delirium tremens and other conditions in older adults.

What is the Diagnosis Code for Alcohol-Induced Delirium Tremens?

The diagnosis code for delirium tremens is ICD-10-CM. This means that delirium tremens can be covered by insurance and treatment costs can be reimbursed in some cases. These codes are designed for medical personnel, insurance companies, and organizations that treat cases of alcohol withdrawal and delirium tremens.

Is Delirium Tremens a Medical Emergency?

Yes, delirium tremens is a medical emergency. Because the condition can lead to seizures and death, it requires medical attention and medication. Therefore, people with symptoms of delirium tremens need to seek medical attention as soon as possible. Without medication, delirium tremens have a 37% mortality rate, which is deadly.

How Long Does Delirium Tremens Last?

Delirium tremens is a dangerous condition but it doesn’t last for a long time. If someone has symptoms of delirium tremens, they typically begin to improve after 2 to 5 days. That said, some symptoms can linger for weeks or months. Still, most symptoms fade over time and people return to normal once symptoms conclude. On the other hand, without medical treatment delirium tremens can be fatal.

How Dangerous is Delirium Tremens?

Delirium tremens is a dangerous conditions. While it’s rare, it has a 37% mortality rate in people that don’t seek medical attention. That said, the condition is treatable with medications that can mitigate the severity of the condition. In these situations, most people with delirium tremens survive the condition and can resume a normal life once treatment concludes.

Can Delirium Tremens Cause Death?

Yes, delirium tremens can cause death. Delirium tremens can cause the heart to stop working, damage organs, and cause severe changes in blood pressure. Moreover, delirium tremens can cause seizures, which can lead to death. If people don’t seek medical attention for delirium tremens, the mortality rate is close to 40%. On the other hand, it’s manageable with medications and medical supervision. Other factors can lead to alcohol-related death. Some of these include wet brain, liver disease, and more.

How to Prevent Delirium Tremens

The best way to prevent delirium tremens is to not consume alcohol. While it’s okay to have a few drinks every week, consuming 4-5 pints per day over the course of many years increases the risk of developing delirium tremens. Therefore, the best way to prevent the alcohol withdrawal that causes delirium tremens is to simply not drink. Another way to prevent delirium tremens is to seek medical attention during the early phases of alcohol withdrawal. Seeking treatment immediately can prevent delirium tremens from being a symptom of alcohol withdrawal.

What is the Treatment of Delirium Tremens?

Delirium tremens require medical treatment. The first stage of treatment is alcohol detox, which typically occurs at a medically-assisted detox facility. Because delirium tremens appear in the late stages of alcohol withdrawal, people who have a high risk of developing the condition are typically given sedatives. Using sedatives can prevent delirium tremens from occurring. There is also supportive care for delirium tremens. This includes IV medications and vitamins and behavioral therapy to monitor patients.

What Medications are Used to Treat Delirium Tremens?

Delirium tremens is a condition that’s treated with a handful of medications and medical procedures. First and foremost, doctors prescribe sedatives to calm the mind and body during the withdrawal process. During this period, doctors may also use intravenous medications and vitamins to keep the body healthy. Some common medications used to treat delirium tremens include lorazepam, diazepam, and chlordiazepoxide.

What are the Other Health Risks of Alcoholism?

Alcoholism causes many health risks. While delirium tremens occur during alcohol withdrawal, there are other conditions that can develop after abusing alcohol for many years. For example, alcohol and liver disease is common in individuals that consume copious amounts of alcohol over a long period.

Some other health risks of alcoholism are listed below.

  • Heart disease
  • Diabetes
  • Liver failure
  • Stomach ulcers
  • Cancers
  • Wet brain syndrome
  • Death

These are only a handful of the health risks that come with consuming alcohol.