Delirium Tremens

Delirium tremens is the worst form of alcohol withdrawal. It usually happens 2 to 4 days after the last drink, but it may occur up to 7 to 10 days after the last drink. It involves sudden and severe changes in your mental and nervous system. Many people keep drinking to get rid of the discomfort felt during delirium tremens. Symptoms may last up to 7 days. Delirium tremens is a serious condition and can be life-threatening. Most people need treatment in a hospital or a detox unit for intravenous (IV) fluids, medicines to help with symptoms, and close monitoring by a trained staff.


Delirium tremens can occur when you suddenly quit or greatly reduce the amount of alcohol you normally drink.


  • Fast heart rate.

  • Elevated temperature.

  • High blood pressure.

  • Seizures.

  • Tremors.

  • Sweating.

  • Fast breathing.

  • Anxiety.

  • Lack of coordination.

  • Trouble thinking clearly.

  • Nausea.

  • Seeing, hearing, or feeling things that are not really there (hallucinations).


  • The diagnosis is usually made from the history of alcohol consumption and the presence of symptoms.

  • Medical tests may be done to rule out other conditions that can act like alcohol withdrawal.


  • Medicines are usually prescribed to prevent withdrawal symptoms. Some people need a calming drug (sedative) for a week or more until they are done with their withdrawal.

  • Going to the hospital is necessary if you are seriously ill. You may be given:

  • Thiamine to prevent a serious brain disorder.

  • Multivitamins and folate.

  • IV fluids if you are dehydrated.

  • Minerals.

  • Sedatives if you are anxious, agitated, or cannot sleep.


After treatment, you must:

  • Follow all instructions from your caregiver very carefully.

  • Take all medicines as prescribed. If you cannot, call your caregiver right away.

  • Keep all appointments for further evaluation and counseling.

  • Not use drugs, alcohol, or any other mind-altering or mood-altering drugs.

  • Not operate a motor vehicle or hazardous machinery until your caregiver says it is okay.


  • You have a seizure (convulsions).

  • You become very shaky or agitated.

  • You have severe nausea and vomiting.

  • You throw up blood. This may be bright red or look like black coffee grounds.

  • You have blood in your stool. This may be bright red, bad smelling, or appear black and tarry.

  • You become lightheaded or faint.

If you have any of the above symptoms, do not drive. Have someone else drive you, or call your local emergency services (911 in U.S.).


  • Treatment centers are listed in telephone book under: Alcoholism and Addiction Treatment, Substance Abuse Treatment or Cocaine, Narcotics, and Alcoholics Anonymous. Most hospitals and clinics can refer you to a specialized care center.

  • The US government maintains a toll-free number for getting treatment referrals: 1-800-662-4357 or 1-800-487-4889 (TDD). They also maintain a website: Other websites for more information are: and

  • In Canada, treatment centers are listed in the telephone book under each Province. Listings are available under: The Ministry for Health Services or similar titles.