Alcohol Withdrawal Delirium/ Delirium Tremens
Definition
Management
Source
Toronto Notes 2012
- Occurs within 12 to 48 h after prolonged heavy drinking and can be life-threatening
- 4 stages (not all stages may be experienced):
- Stage 1 (onset 6-12 h after last drink): tremor, sweating, agitation, anorexia, cramps, diarrhoea, sleep disturbance
- Stage 2 (onset 1-7 d): visual, auditory, olfactory or tactile hallucinations
- Stage 3 (onset 12-72 hand up to 7 d): seizures, usually tonic-clonic, nonfocal and brief
- Stage 4 (onset 3-5 d): delirium tremens, confusion, delusions, hallucinations, agitation, tremors, autonomic hyperactivity (fever, tachycardia, hypertension)
- Course: in young almost completely reversible; elderly often left with cognitive deficits
- Mortality rate 20% if untreated
Management
- Admit to hospital
- Diazepam
- Thiamine IM
- Haloperidol/ Atypical antipsychotics (if hallucinating)
Source
Toronto Notes 2012