![Delirium tremens (DTs; lit. 'shaking frenzy') is a rapid onset of confusion usually caused by withdrawal from alcohol.[2] When it o](https://upload.wikimedia.org/wikipedia/commons/thumb/5/5f/An_alcoholic_man_with_delirium_Wellcome_L0060780_%28level_correction%29.jpg/1200px-An_alcoholic_man_with_delirium_Wellcome_L0060780_%28level_correction%29.jpg "Delirium tremens - Wikipedia")
Delirium tremens - Wikipedia
Delirium tremens (DTs; lit. 'shaking frenzy') is a rapid onset of confusion usually caused by withdrawal from alcohol.[2] When it occurs, it is often three days into the withdrawal symptoms and lasts for two to three days.[2] Physical effects may include shaking, shivering, irregular heart rate, and sweating.[1] People may also hallucinate.[2] Occasionally, a very high body temperature or seizures (colloquially known as "rum fits")[5][6] may result in death.[2] Alcohol is one of the more dangerous drugs to withdraw from.[7]
Delirium tremens typically occurs only in people with a high intake of alcohol for more than a month.[8] A similar syndrome may occur with benzodiazepine and barbiturate withdrawal.[3] Withdrawal from stimulants, such as cocaine and amphetamines, does not have major medical complications.[9] In a person with delirium tremens it is important to rule out other associated problems such as electrolyte abnormalities, pancreatitis, and alcoholic hepatitis.[2]
Prevention is by treating withdrawal symptoms using similarly acting compounds to taper off the use of the precipitating substance in a controlled fashion.[2] If delirium tremens occurs, aggressive treatment improves outcomes.[2] Treatment in a quiet intensive care unit with sufficient light is often recommended.[2] Benzodiazepines are the medication of choice with diazepam, lorazepam, chlordiazepoxide, and oxazepam all commonly used.[8] They should be given until a person is lightly sleeping.[2] Non-benzodiazepines are often used as adjuncts to manage the sleep disturbance associated with condition. The antipsychotic haloperidol may also be used,[2] as a major tranquilizer, in order to combat the overactivity and possible excitotoxicity caused by the withdrawal from a GABA-ergic sedative. The vitamin thiamine is recommended to be given intramuscularly,[2] because long term high alcohol intake and the often attendant nutritional deficit damages the small intestine, and so leads to a thiamine deficiency which sometimes cannot be rectified by supplement pills alone.
