What Is Delirium Tremens (DT)?

Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatmentComplicationsCoping

Table of ContentsView All

View All

Table of Contents

Causes

Symptoms

Diagnosis

Treatment

Complications

Coping

What is the most important information I should know about DT?Alcohol withdrawal can be dangerous and potentially fatal. If youplan to quit, you should:consult with a healthcare provider; orseek treatment from aprofessional detoxification facility.

What is the most important information I should know about DT?

Alcohol withdrawal can be dangerous and potentially fatal. If youplan to quit, you should:consult with a healthcare provider; orseek treatment from aprofessional detoxification facility.

Alcohol withdrawal can be dangerous and potentially fatal. If youplan to quit, you should:

Delirium tremens, also known as DTs oralcohol withdrawal syndrome, is the most severe form of alcohol withdrawal and can be fatal if not appropriately managed.While people sometimes go through this process at home, it is common for those who want to quit drinking to withdraw and detoxify from alcohol at a medical facility.

Alcohol is a depressant, which slows down the central nervous system. Chronic, heavy alcohol use can change how the brain works, including how chemical messengers function. When alcohol consumption suddenly stops, the brain continues working in the state it has become used to, leading to symptoms of alcohol withdrawal.

DTs typically begin after a person gives up alcohol following a binge or otherperiod of heavy drinking, but they don’t usually start immediately. A period of milder alcohol withdrawal often exists at first, with symptoms becoming increasingly more severe after 48 to 72 hours—although symptoms can begin as long as seven to 10 days after quitting drinking.

The delirium tremens experience can vary from one person to another, depending, in part, on the level of previous alcohol use. DTs are more common among people with a history of heavy, long-term alcohol consumption, and between 3% and 5% of peoplequitting alcoholwill have delirium tremens symptoms.

Delirium tremens is serious and potentially fatal. If you or someone you know is experiencing symptoms of this condition, call 911 or seek emergency medical care immediately.

Stages of Alcohol Withdrawal Symptoms

Causes of Delirium Tremens

Delirium tremens can occur if you have a high alcohol intake, then reduce alcohol consumption quickly or suddenlystop drinking altogether. DTs are even more probable when food consumption is lower too.

People are are more likely to develop DT symptoms if they drink heavily over the span of several months (or years). That could mean:

Older people are at higher risk of increasedblood alcohol levels, increasing their risk of withdrawal. This is due to decreases in liver function and brain neuron receptivity with age, in addition to also having reduced body water and body mass levels.

The risk of developing delirium tremens is higher if you’ve had alcohol withdrawal or delirium tremens in the past, or if you have a seizure disorder. If a person with heavy alcohol use has ahead injury, infection, or illness, this can also contribute to DTs.

Delirium Tremens Symptoms

Delirium tremens symptoms can be both physical and psychological.

Physical Symptoms

Physical symptoms of delirium tremens can include:

Psychological Symptoms

Along with physical symptoms, psychological symptoms are also common with DTs and can include:

DT symptoms typically resolve in a few days but are serious and should receive medical attention. If you or someone you know has signs of delirium tremens, seek medical care immediately.

Alcohol Withdrawal Symptoms: Mild to Severe

Diagnosis of Delirium Tremens

To diagnose delirium tremens, a healthcare provider considers medical history and symptoms and may conduct a physical exam. They will likely check for fever and dehydration, also listening to the heart to see if its beat is rapid or irregular.

Some healthcare providers administer an assessment known as theClinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar)when diagnosing DTs. This assessment can help them gauge the nature andseverity of symptoms.

Testing

A healthcare provider may conduct a variety of other tests to help diagnose delirium tremens, including:

Treatment for Delirium Tremens

DTs are a medical emergency that requires hospitalization, as they can lead to potentially deadly cardiovascular issues.

In the past, the mortality rate for people with DTs was around 35%. Advances in both diagnosis and care have dropped this rate to 2%.The most common causes of death for patients with delirium tremens are cardiac arrhythmia and respiratory failure.

Acute Care

DT treatment may initially include the use ofbenzodiazepine medicationsto reduce the symptoms of alcohol withdrawal.Some of the medications used to treat delirium tremens includeAtivan(lorazepam) andLibrium(chlordiazepoxide). These medicines can help relieve the anxiety associated with severe, acute alcohol withdrawal.

Heavy alcohol use can also result innutritional deficiencies. So when starting DT treatment, a healthcare provider may also recommend vitamins and mineral supplements, such as thiamine, zinc, phosphate, magnesium, and folate.

Long-Term Treatment

Once health and safety have been addressed, treatment may then focus on long-term approaches to aid in recovery from alcohol dependence. These treatments can includegroup therapy,cognitive behavioral therapy(CBT), and sobriety support groups.

If you need help to stop drinking, there are resources that can help you. Groups such asAlcoholics AnonymousandAl-Anoncan provide information and offer social support as you go through this process. You can evenattend meetings online.

In addition to delirium tremens, heavy alcohol use can cause other complications that also require treatment. Among them are:

Other health problems that can occur from long-term, excessive alcohol use include stroke, digestive problems, cancer, mental health problems (such asdepression), and weakening of the immune system.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

Coping With Delirium Tremens

Alcohol withdrawal can be both unpredictable and dangerous, making medical help necessary for a safer recovery—particularly when DT symptoms are present. That said, there are still a few steps you can take to better cope with withdrawal symptoms and promote recovery. They include:

Treatment Options for Alcohol Withdrawal Symptoms

17 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Experim Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012Day E, Daly C.Clinical management of the alcohol withdrawal syndrome.Addiction. 2022;117(3):804-814. doi:10.1111/add.15647Schuckit MA.Recognition and management of withdrawal delirium (delirium tremens).N Engl J Med. 2014;371(22):2109-13. doi:10.1056/NEJMra1407298U.S. National Library of Medicine.Delirium tremens.Elliott D.Caring for hospitalized patients with alcohol withdrawal syndrome.Nurs Critic Care. 2019;14(5):18-30. doi:10.1097/01.CCN.0000578828.37034.c2Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: mechanisms, manifestations, and management.Acta Neurol Scand. 2017;135(1):4-16. doi:10.1111/ane.12671Rappaport D, Chuu A, Hullett C, et al.Assessment of alcohol withdrawal in Native American patients utilizing the Clinical Institute Withdrawal Assessment of Alcohol Revised scale.J Addict Med. 2013;7(3):196-99. doi:10.1097/ADM.0b013e31828b3cc3Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs. 2015; 75(4); 353-365. doi:10.1007/s40265-015-0358-1Ignjatovic-Ristic D, Rancic N, Novokmet S, Jankovic S, Stefanovic S.Risk factors for lethal outcome in patients with delirium tremens - psychiatrist’s perspective: a nested case-control study.Ann Gen Psychiat. 2013;12:39. doi:10.1186/1744-859X-12-39Mainerova B, Prasko J, Latalova K, et al.Alcohol withdrawal delirium - diagnosis, course and treatment.Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(1):44-52. doi:10.5507/bp.2013.089Attilia F, Perciballi R, Rotondo C, et al.Alcohol withdrawal syndrome: diagnostic and therapeutic methods.Riv Psichiatr. 2018;53(3):118-122. doi:10.1708/2925.29413Gray R, Kouadio A, Daeppen JB.[Nutrition disorders and alcohol use disorder].Rev Med Suisse. 2019;15(654):1177-1180.National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on the body.U.S. National Library of Medicine.Alcoholic neuropathy.National Organization for Rare Disorders.Wernicke-Korsakoff syndrome.Centers for Disease Control and Prevention.Alcohol use and your health.Substance Abuse and Mental Health Services Administration.Detoxification and substance abuse treatment [Internet].

17 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Experim Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012Day E, Daly C.Clinical management of the alcohol withdrawal syndrome.Addiction. 2022;117(3):804-814. doi:10.1111/add.15647Schuckit MA.Recognition and management of withdrawal delirium (delirium tremens).N Engl J Med. 2014;371(22):2109-13. doi:10.1056/NEJMra1407298U.S. National Library of Medicine.Delirium tremens.Elliott D.Caring for hospitalized patients with alcohol withdrawal syndrome.Nurs Critic Care. 2019;14(5):18-30. doi:10.1097/01.CCN.0000578828.37034.c2Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: mechanisms, manifestations, and management.Acta Neurol Scand. 2017;135(1):4-16. doi:10.1111/ane.12671Rappaport D, Chuu A, Hullett C, et al.Assessment of alcohol withdrawal in Native American patients utilizing the Clinical Institute Withdrawal Assessment of Alcohol Revised scale.J Addict Med. 2013;7(3):196-99. doi:10.1097/ADM.0b013e31828b3cc3Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs. 2015; 75(4); 353-365. doi:10.1007/s40265-015-0358-1Ignjatovic-Ristic D, Rancic N, Novokmet S, Jankovic S, Stefanovic S.Risk factors for lethal outcome in patients with delirium tremens - psychiatrist’s perspective: a nested case-control study.Ann Gen Psychiat. 2013;12:39. doi:10.1186/1744-859X-12-39Mainerova B, Prasko J, Latalova K, et al.Alcohol withdrawal delirium - diagnosis, course and treatment.Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(1):44-52. doi:10.5507/bp.2013.089Attilia F, Perciballi R, Rotondo C, et al.Alcohol withdrawal syndrome: diagnostic and therapeutic methods.Riv Psichiatr. 2018;53(3):118-122. doi:10.1708/2925.29413Gray R, Kouadio A, Daeppen JB.[Nutrition disorders and alcohol use disorder].Rev Med Suisse. 2019;15(654):1177-1180.National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on the body.U.S. National Library of Medicine.Alcoholic neuropathy.National Organization for Rare Disorders.Wernicke-Korsakoff syndrome.Centers for Disease Control and Prevention.Alcohol use and your health.Substance Abuse and Mental Health Services Administration.Detoxification and substance abuse treatment [Internet].

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Experim Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012Day E, Daly C.Clinical management of the alcohol withdrawal syndrome.Addiction. 2022;117(3):804-814. doi:10.1111/add.15647Schuckit MA.Recognition and management of withdrawal delirium (delirium tremens).N Engl J Med. 2014;371(22):2109-13. doi:10.1056/NEJMra1407298U.S. National Library of Medicine.Delirium tremens.Elliott D.Caring for hospitalized patients with alcohol withdrawal syndrome.Nurs Critic Care. 2019;14(5):18-30. doi:10.1097/01.CCN.0000578828.37034.c2Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: mechanisms, manifestations, and management.Acta Neurol Scand. 2017;135(1):4-16. doi:10.1111/ane.12671Rappaport D, Chuu A, Hullett C, et al.Assessment of alcohol withdrawal in Native American patients utilizing the Clinical Institute Withdrawal Assessment of Alcohol Revised scale.J Addict Med. 2013;7(3):196-99. doi:10.1097/ADM.0b013e31828b3cc3Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs. 2015; 75(4); 353-365. doi:10.1007/s40265-015-0358-1Ignjatovic-Ristic D, Rancic N, Novokmet S, Jankovic S, Stefanovic S.Risk factors for lethal outcome in patients with delirium tremens - psychiatrist’s perspective: a nested case-control study.Ann Gen Psychiat. 2013;12:39. doi:10.1186/1744-859X-12-39Mainerova B, Prasko J, Latalova K, et al.Alcohol withdrawal delirium - diagnosis, course and treatment.Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(1):44-52. doi:10.5507/bp.2013.089Attilia F, Perciballi R, Rotondo C, et al.Alcohol withdrawal syndrome: diagnostic and therapeutic methods.Riv Psichiatr. 2018;53(3):118-122. doi:10.1708/2925.29413Gray R, Kouadio A, Daeppen JB.[Nutrition disorders and alcohol use disorder].Rev Med Suisse. 2019;15(654):1177-1180.National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on the body.U.S. National Library of Medicine.Alcoholic neuropathy.National Organization for Rare Disorders.Wernicke-Korsakoff syndrome.Centers for Disease Control and Prevention.Alcohol use and your health.Substance Abuse and Mental Health Services Administration.Detoxification and substance abuse treatment [Internet].

Grover S, Ghosh A.Delirium tremens: Assessment and management.J Clin Experim Hepatol. 2018;8(4):460-470. doi:10.1016/j.jceh.2018.04.012

Day E, Daly C.Clinical management of the alcohol withdrawal syndrome.Addiction. 2022;117(3):804-814. doi:10.1111/add.15647

Schuckit MA.Recognition and management of withdrawal delirium (delirium tremens).N Engl J Med. 2014;371(22):2109-13. doi:10.1056/NEJMra1407298

U.S. National Library of Medicine.Delirium tremens.

Elliott D.Caring for hospitalized patients with alcohol withdrawal syndrome.Nurs Critic Care. 2019;14(5):18-30. doi:10.1097/01.CCN.0000578828.37034.c2

Jesse S, Bråthen G, Ferrara M, et al.Alcohol withdrawal syndrome: mechanisms, manifestations, and management.Acta Neurol Scand. 2017;135(1):4-16. doi:10.1111/ane.12671

Rappaport D, Chuu A, Hullett C, et al.Assessment of alcohol withdrawal in Native American patients utilizing the Clinical Institute Withdrawal Assessment of Alcohol Revised scale.J Addict Med. 2013;7(3):196-99. doi:10.1097/ADM.0b013e31828b3cc3

Mirijello A, D’Angelo C, Ferrulli A, et al.Identification and management of alcohol withdrawal syndrome.Drugs. 2015; 75(4); 353-365. doi:10.1007/s40265-015-0358-1

Ignjatovic-Ristic D, Rancic N, Novokmet S, Jankovic S, Stefanovic S.Risk factors for lethal outcome in patients with delirium tremens - psychiatrist’s perspective: a nested case-control study.Ann Gen Psychiat. 2013;12:39. doi:10.1186/1744-859X-12-39

Mainerova B, Prasko J, Latalova K, et al.Alcohol withdrawal delirium - diagnosis, course and treatment.Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(1):44-52. doi:10.5507/bp.2013.089

Attilia F, Perciballi R, Rotondo C, et al.Alcohol withdrawal syndrome: diagnostic and therapeutic methods.Riv Psichiatr. 2018;53(3):118-122. doi:10.1708/2925.29413

Gray R, Kouadio A, Daeppen JB.[Nutrition disorders and alcohol use disorder].Rev Med Suisse. 2019;15(654):1177-1180.

National Institute on Alcohol Abuse and Alcoholism.Alcohol’s effects on the body.

U.S. National Library of Medicine.Alcoholic neuropathy.

National Organization for Rare Disorders.Wernicke-Korsakoff syndrome.

Centers for Disease Control and Prevention.Alcohol use and your health.

Substance Abuse and Mental Health Services Administration.Detoxification and substance abuse treatment [Internet].

Meet Our Review Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?HelpfulReport an ErrorOtherSubmit

What is your feedback?