Delirium tremens

Delerium tremens is a medical emergency. It is an acute confusional state associated with tremor and autonomic dysfunction.

The essential feature, as defined by DSM-IIIR, is that it develops within one week following the cessation of heavy ingestion of alcohol or a reduction in the amount of alcohol ingested.

Treatment for delirium tremens or seizures

• offer oral lorazepam as first-line treatment for delirium tremens. If symptoms persist or oral medication is declined, give parenteral lorazepam, haloperidol or olanzapine
• for people with alcohol withdrawal seizures, consider offering a quick-acting benzodiazepine (such as lorazepam) to reduce the likelihood of further seizures
• if delirium tremens or seizures develop in a person during treatment for alcohol withdrawal, review their withdrawal drug treatment
• do not offer phenytoin to treat alcohol withdrawal seizures

Reference:

• 1) NICE (June 2010). Alcohol use disorders.