Alcoholics are often brought reluctantly by their relatives who can see more clearly than the patient how seriously his life is being interfered with by his addiction. Delirium tremens is a serious condition which may occur 6 to 90 hours after withdrawal of alcohol. It may also develop after a person suddenly stops taking sedatives or hypnotics.
The condition is characterized by gross tremors in hands and finger, restlessness, confusion, misidentification of people and places, and delusional ideas. Delirium tremens is a life threatening condition and the mortality rate may be as high as 30 to 40 % if not treated in time.
Fortunately, most cases of delirium tremens are benign and short in duration which ends suddenly as it had begun. Only 5% of patients develop the symptoms of delirium tremens due to alcohol withdrawal. Delirium tremens is life threatening and must require hospitalization.
Causes Of Delirium Tremens
The most likely cause for delirium tremens is sudden stoppage of drinking alcohol after a period of drinking out of proportion for a long period of time. It is more common when the food intake of a person is less. As a result imbalance of chemicals develop giving rise to number of symptoms.Same condition can occur after abrupt stoppage of barbiturates and other benzodiazepine drugs. It is mainly to do with imbalance of GABA receptors in the brain.
Delirium tremens also develop after brain injury, infections in brain, and diseases related to alcoholism. The condition is commonly seen after alcohol withdrawal. Especially people who drink alcohol in large amount everyday for many years are susceptible to develop delirium tremens.
Signs And Symptoms Of Delirium Tremens
The symptoms of delirium tremens develop within 6 to 72 hours after the person has stopped drinking. The symptoms may be brief or may even last for a week, often with fluctuations in which the patient appears better at times, worse at others. The most striking symptoms of delirium tremens are as follows:
The onset begins with tremors of fingers which may over a period of time intensify. It is sudden in onset. There is clouding of consciousness along with confusion, disordered speech, and difficulty in comprehension. Patient may not be able to indentify person and there is total disorientation of time and place. There may be overwhelming fear with nausea, vomiting and sweating.
Auditory delusions and visual hallucinations are common in severe form of the disease; patient may sit cheerfully on the edge of his bed, convinced that he was engaged in trout fishing. He may have abstract feeling of an insect crawling under his skin.
Hypertension and rapid pulse rate are often present with perspiration. The symptoms are worse in evening and at night and may be accompanied with nightmares. Most patients with delirium tremens have moderate to high grade fever.
Treatment Of Delirium Tremens
Delirium tremens requires medical attention as soon as possible, preferably in the hospital ICU.
While waiting for the medical help, approach the patient in a calm and reassuring manner. If possible keep the person in a quiet environment. Keep the light dim but do not make the room totally dark. Patient should be watched closely to protect him from any type of self injury. Try to see that the patient eats and drinks adequately. If there is high fever, cold sponging may reduce the temperature.
- Holistic approach may be found useful when the medical assistance is delayed. A homeopathic drug such as Gelsimium has been found useful in treating tremors.
- St. John’s Wort is another herb found beneficial to calm and soothe the agitation and restlessness present during withdrawal and delirium tremens.
- Vitamins, especially B group vitamins benefit patients to alleviate the symptoms.