Author: Gary Jackson

Delirium Tremens DT: Definition, Symptoms, Treatment

Many people with DTs also have dehydration, electrolyte imbalances or mineral deficiencies. Your healthcare provider can treat these by infusing you (through an IV in your vein) with the necessary vitamins and minerals. Some infusions come specially prepared for this type of situation. An example of this is an infusion that healthcare providers often refer to by the nickname “banana bag” (because the solution in them is yellow). It contains vitamin B1 (thiamine), B9 (folate), a multivitamin, electrolyte solution and more.

Because confusion is a key symptom of DTs, people with this condition can’t make informed choices about their care. It may be necessary for family or loved ones to make decisions if you can’t make choices for yourself. In the 1995 film Leaving Las Vegas, Nicolas Cage plays a suicidal alcoholic who rids himself of all his possessions and travels to Las Vegas to drink himself to death. During his travels, he experiences delirium tremens on a couch after waking up from a binge and crawls in pain to the refrigerator for more vodka.

Conditions

Sedatives, usually benzodiazepines, are medications used to treat alcohol withdrawal and DTs. If your symptoms can’t be managed with sedatives, your doctor may prescribe anesthesia so you will be completely sedated until your symptoms end. You may also need intravenous fluids with vitamins and minerals to treat dehydration or bring your electrolytes back into balance. If you or someone else experiences symptoms of delirium tremens—tremors, confusion, changes of consciousness, or shaking—then it’s important to seek medical attention right away.

• Alcohol interacts with GABA receptors, chloride ion receptor acting as an inhibitory neurotransmitter, via several mechanisms to enhance its activity.
• Delirium tremens can occur if you have a high alcohol intake, then reduce alcohol consumption quickly or suddenly stop drinking altogether.
• In a symptom-triggered regimen, medications are usually given when symptoms are present, sometimes using a CIWA score greater than 8.
• English author George Eliot provides a case involving delirium tremens in her novel Middlemarch (1871–72).
• People with delusional disorder may be unlikely to seek treatment because they may not realize that their delusional beliefs are not true.
• One main and serious symptom is the occurrence of hallucinations, which need to be treated by a doctor.

They help lower activity in your CNS, which is the source of most of the dangerous problems with DTs. The most common sedatives are benzodiazepines, but other drug types are possible, too. In rare situations, people with very high CNS activity may need general anesthesia to fully sedate them and avoid the most dangerous symptoms of DTs.

Treatment / Management

If you need help to stop drinking, there are resources that can help you. Groups such as Alcoholics Anonymous and Al-Anon can provide information and offer social support as you go through this process. R. James mentions delirium tremens in his 1904 ghost story “‘Oh, Whistle, and I’ll Come to You, My Lad'”. American writer Mark Twain describes an episode of delirium tremens in his book The Adventures of Huckleberry Finn (1884). French writer Émile Zola’s novel The Drinking Den (L’Assommoir) includes a character – Coupeau, the main character Gervaise’s husband – who has delirium tremens by the end of the book. Sometimes, an electroencephalogram (EEG) might be needed to assess brain function if a person is unresponsive.

Recognizing individuals with a history of alcohol use disorder can help prevent the progression of withdrawal symptoms. There is a lack of consensus on the prophylactic treatment of alcohol withdrawal. Variations in hospital-wide policies in treating alcohol withdrawal exist, and the medications used include benzodiazepines and even gabapentin. You are more likely to have DTs if you have moderate or severe alcohol use disorder (heavy or frequent alcohol use even if it causes physical or emotional harm). Nearly one-third of U.S. adults will have alcohol use disorder at some point in their lives, and it is estimated that about 1% of those people may get delirium tremens. If untreated, delirium tremens can cause severe symptoms including heart attack, stroke, and death.

Monitoring During Delirium Tremens Treatment

DTs can develop in anyone who meets the criteria for heavy alcohol use. For people AMAB, that means drinking three or more drinks per day and 15 or more drinks per week. For people AFAB, that means drinking two or more drinks per day and eight or more drinks per week. However, DTs becomes more and more likely the more you drink and the longer this continues. Because of these symptoms, you won’t be able to make decisions about your medical care. Healthcare providers will treat you to stabilize you (unless you have some kind of advance medical directive on file with them).

• You can learn to recognize the signs of delirium tremens, but since disorientation is a key feature of the condition, most people cannot recognize their own symptoms.
• Alcohol use disorder isn’t a condition that happens for just one reason.
• Your CNS controls your body’s automatic processes like breathing and heart rate.

Irish singer-songwriter Christy Moore has a song on his 1985 album, Ordinary Man, called “Delirium Tremens” which is a satirical song, directed towards the leaders in Irish politics and culture. One of the characters in Joseph Conrad’s novel Lord Jim experiences “DTs of the worst kind” with symptoms that include seeing millions of pink frogs. English author George Eliot provides a case involving delirium tremens in her novel Middlemarch (1871–72).

Doctors may also check your liver, heart, nerves in your feet, and your digestive system to figure out the level of alcohol damage to your body. However, these conditions tend to be accompanied by several other symptoms in addition to delusions, such as hallucinations, disorganized thinking, and abnormal motor behavior, for instance. Delusional disorder is a psychotic disorder that can make it hard for a person to distinguish between what’s real and what’s imagined to be true. The primary symptom of this condition is the presence of delusions, which are irrational, unshakeable beliefs that are untrue.

One main and serious symptom is the occurrence of hallucinations, which need to be treated by a doctor. The only way to prevent delirium tremens is to stop, or dramatically reduce, your alcohol intake. You may be concerned about having DTs symptoms or nervous about seeking treatment. Your doctor and other providers aren’t there to judge you but to help manage your symptoms and improve your chances of recovery. When you suddenly stop drinking after a long period of alcohol use, your brain and nervous system can’t adjust quickly.