Delirium Tremens and Alcohol Withdrawal: Symptoms and Treatment

delirium tremens alcohol withdrawal

Withdrawal. Simply upon hearing the world, many unpleasant images and ideas come to mind. However, people are often unclear as to what withdrawal actually means.

They wonder about symptoms of alcohol withdrawal and about what reactions this might develop in the person struggling with alcohol addiction.

  • Does it affect psychological functioning or only physical? 
  • Can it happen to any drinker? 
  • How is it treated?

Answers can be found, and clarity about withdrawal can be gained. Delirium tremens is no exception, and it is one of the most common manifestations associated with alcohol withdrawal.

What are other names for delirium tremens?

Delirium tremens is often abbreviated as DTs. It has been called alcohol withdrawal delirium. It can also be more broadly categorized an alcohol withdrawal symptom.

When does delirium tremens occur?

DTs most frequently occurs in cases where individuals have engaged in heavy drinking and then alter this behavior.

As Harvard Health Publication indicates, delirium tremens symptoms frequently begin manifesting 2 to 3 days after the last alcoholic drink although they can appear as late as a week after the last drink. Around 4 to 5 days after the last drink is when the peaked intensity can be expected.

Who can develop delirium tremens?

As the University of Maryland Medical Center points out, DTs often occurs with alcoholics who have been struggling with their addiction for over ten years although DTs can occur simply after consistent heavy drinking that does not span such a long range of time.

They stipulate amounts of daily alcoholic consumption that can lead to DTs over a period of months:

  • 4-5 pints of wine
  • 1 pint of “hard” alcohol
  • 7-8 pints of beer

What is it like to experience delirium tremens?

Symptoms of DTs have been indicated by Harvard Health Publication and by Medline Plus’s Medical Encyclopedia accessed through the U.S. National Library of Medicine. The experience may include:

  • Increase in blood pressure
  • Racing heart
  • Body tremors
  • Shifts in breathing, circulation, and temperature control
  • Dehydration
  • Reduction of blood flow to the brain
  • Hallucinations
  • Restlessness
  • Seizures

Medline Plus’s Medical Encyclopedia also puts forward other symptoms of alcohol withdrawal that may concurrently manifest:

  • Palpitations
  • Sweating
  • Appetite loss
  • Headache
  • Shakiness

Does delirium tremens have psychological symptoms?

DTs often results in not only physical symptoms but also cognitive symptoms. Medicine Plus’s Medical Encyclopedia and Harvard Health Publications puts forward some psychological effects that may incur:

  • Confusion
  • Disorientation
  • Quick mood changes
  • Nervous or angry behavior
  • Depression

Can other disorders or diseases be co-current?

Diagnosis of DTs can often be made more difficult by the existing of co-current problems that disguise the issue of DTs. This can lead to worsened outcome of DTs and other medical problems as stated by an article made available through the National Institute of Alcohol Abuse and Alcoholism.

Medline Plus’ Medical Encyclopedia stipulate some of the potential co-occurring problems:

  • Alcoholic neuropathy
  • Alcoholic cardiomyopathy
  • Wernicke-Korsakoff syndrome
  • Alcoholic liver disease

What are treatment options for delirium tremens?

Treatment for delirium tremens can be beneficial to not only relieve immediate symptoms but also help monitor and address potentially life-threatening developments. Treatment can also aid in long-term recovery.

An article accessed through the National Institute of Alcohol Abuse and Alcoholism puts forward common facets of treatment: maintenance of electrolyte and water balance and correcting metabolic disturbances. 

Different types of treatment exist. As always, consult your medical professional when determining which treatment option might be right for you or for someone you know who is struggling through withdrawal symptoms.

Pharmaceutical Options

Medicinal options can make a difference when facing alcohol withdrawal symptoms such as DTs. Certain medicines can be described in such cases as put forward by Hugh Myrick (M.D.) and Raymond F. Anton (M.D.) in an article accessed through the National Institute of Alcohol Abuse and Alcoholism:

  • Benzodiazepines (BZs): type of sedative commonly used to treat seizures, anxiety, and insomnia (although some purport that such medication increases aggressive behavior)
  • Adrenergic Medications: factor to regulate the nervous system and, thus, target elevated pulse and blood pressure
  • Antiseizure Medications: target seizures, appear to have much-diminished abuse potential, and are less sedative than BZs.

Medical Detox

In some cases of DTs, the symptoms can be quite severe. Medical detox can be an option to best address existing symptoms or prevent the development of life-threatening conditions.

Alternative Therapies

Engaging in alternative therapies can lead to some diminished symptoms of DTs. Further, alternative therapies can provide options for sustainable recovery.

Some therapy suggestions for sustainable recovery include counseling, support group attendance, and implementing a plan for alcohol avoidance or abstinence. 


“Alcohol Withdrawal: What Is it?” Harvard Health Publications: Harvard Medical School. Web. 12 July 2016. <http://www.health.harvard.edu/diseases-and-conditions/alcohol-withdrawal->.
Anton, Raymond F. & Myrick, Hugh. “Treatment of Alcohol Withdrawal.” National Institute on Alcohol Abuse and Alcoholism. National Institutes of Health,1988. Web. 12 July 2016. <http://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf>.
Boutros, Nashaat, Krystal, John H., Petrakis, Ismene L., and Trevisan, Louis A. “Complications of Alcohol Withdrawal: Pathophysiological Insights.” National Institute of Alcohol Abuse and Alcoholism. National Institutes of Health, 1998. Web. 12 July 2016. <http://pubs.niaaa.nih.gov/publications/arh22-1/61-66.pdf>.
“Delirium Tremens.” MedlinePlus Medical Encyclopedia. National Institutes of Health: U.S National Library of Medicine. Web. 12 July 2016. <https://medlineplus.gov/ency/article/000766.htm>.
Martin, Laura J. “Delirium Tremens.” University of Maryland Medical Center. 8 February 2015. Web. 11 July 2016. <http://umm.edu/health/medical/ency/articles/delirium-tremens>.