Delirium tremens is a condition that occurs in chronic alcoholics after sudden alcohol withdrawal.
It is characterized by neuropsychiatric symptoms such as tremors, hallucinations, confusion, agitation, excessive speech (verbiage), and signs of autonomic hyperactivity, such as tachycardia.
Delirium tremens is a serious, potentially life-threatening syndrome that occurs in approximately 5% of individuals who experience sudden alcohol withdrawal.
The condition has a mortality rate of around 10%, often due to complications like dehydration from vomiting. It typically appears about 72 hours after the last alcohol intake.
However, delirium tremens can also develop without a significant change in drinking patterns. Thus, emergency departments may encounter patients who, despite continuing to drink alcohol, exhibit the symptoms and signs of the syndrome.
Delirium tremens is primarily associated with the heavy, daily consumption of alcohol over a prolonged period.
Excessive alcohol intake over time inevitably leads to alcohol dependence and, consequently, withdrawal syndrome when alcohol is suddenly reduced or stopped.
It can also be triggered by the use of toxic substances such as cocaine, certain mushrooms (like Amanita muscaria), high doses of some drugs (such as codeine), inhalants like glue, and others.
Additionally, delirium tremens can occur in alcoholics when they experience very high fevers (e.g., 41–42ºC) due to infection or when they suffer a head injury.
A heavy drinker, or someone who has consumed alcohol continuously for ten or more years, may suddenly develop the following symptoms when they stop drinking:
These symptoms usually appear 48 to 96 hours after the last alcoholic drink intake, but in some cases, they may emerge a week later.
If the person has not stopped drinking alcohol, the symptoms may be triggered by factors such as an infection or an injury.
Treatment should begin as soon as possible. The recommended drug is diazepam (Valium). It is advised to administer 10 mg intravenously (IV) over 3 to 5 minutes. If the patient has not calmed down after 20 minutes, an additional dose of 5 mg IV may be given.
While this treatment helps suppress symptoms, it has not been proven to reduce the overall duration of delirium tremens.
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