Delirium tremens is a condition that occurs in binge alcoholics after a long binge on the 2-5th day after a sharp cessation of alcohol (during abstinence and when withdrawing from binge drinking)
Treatment of delirium tremens is possible only in a hospital setting, since it is a severe complication of alcoholism. In the absence of proper treatment, death is possible. Up to 15% of patients die from delirium tremens.
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Delirium tremens: symptoms and consequences
If signs of delirium tremens do not appear within a week after quitting alcohol and provided that there is no treatment and alcohol is not taken in prophylactic doses, then delirium tremens will no longer occur, and you don’t have to worry about it.
As narcologists write and chronic alcoholics confirm on forums, delirium tremens comes on suddenly, often against the background of prolonged insomnia.
The symptoms of alcohol psychosis are quite easy to recognize. First of all, these are elementary hallucinations and hypnagogic illusions - vivid visions and images that arise half asleep, when a person closes his eyes but is not sleeping. Illusions are replaced by oneirism: rapidly changing images and visions from the patient’s life. They are bright, chaotic, the kind that happens in a disturbing dream, but a person sees them in reality.
A person begins to hear noises and sounds that have an imaginary source. He hears music and people calling him. He feels small objects flickering around him, it seems to him that insects are crawling over his body, that they are trying to strangle them, throw them off the bed. People feel the floor, ceilings and walls vibrating.
Other consequences include a series of scene-like hallucinations, when a person sees something like films from his life or the lives of imaginary characters (cartoons). At the same time, the patient himself feels like an active player in these scenes. Most often these are scenes of unpleasant content: a person seems to be forced to run away from someone, hide, defend himself from an attack; he feels anxiety, fear, excitement and restlessness.
Symptoms and consequences are especially clear when examining the patient. Thus, a person is easily suggestible, for example, he can twirl in his hands non-existent objects that were “given” to him, he can talk on the phone without pressing a button, or even holding a spoon or any other object in his hands. With delirium tremens, the Aschaffenburg symptom described above almost always appears. Also common is Lyman's symptom, where a person easily begins to imagine images and hallucinate if they press on their eyeballs while their eyes are closed.
Are there any first signs?
Call urgently!!!
Consequences
Alcohol delirium can cause the development of various diseases. Brain damage in delirium delirium is pronounced. The most typical consequences are:
- Pneumonia – occurs in a third of people with delirium tremens;
- Alcoholic cardiomyopathy – develops in 25% of cases, can lead to the loss of the patient;
- Impaired absorption and metabolism of vitamins;
- Destabilization of acid-base, water-salt balance;
- Pancreatitis;
- Renal and hepatic dysfunction (eg fatty liver);
- Rhabdomyolysis is a syndrome accompanied by the destruction of muscle tissue and extreme myopathy;
- Brain swelling.
Delirium tremens may end:
- Complete recovery;
- Partial recovery – the patient remains in amnestic or organic psychosyndrome;
- Death.
Abstinence from alcohol in general and delirium tremens can be deadly. Before the principles of intensive care and effective pharmacological treatment were developed, mortality due to such forms reached 35%. In the modern world, this figure varies between 5 and 15%.
The course of delirium tremens: how long does it last?
Delirium tremens is incurable at home, but you can observe the person for several hours. An abortive form of delirium tremens after binge drinking is uncommon, which goes away automatically within a few hours after the onset. In this case, the symptoms end, the person falls into a somnambulistic state or falls asleep. He may be awake, but he no longer shows signs of psychosis.
If in alcoholics these symptoms last up to 2-4 days, then this can be called a moderate form of the disease. How long does delirium tremens last, from which you can say goodbye to life? As a rule, it takes more than a week, and even in a hospital setting the symptoms are extremely difficult to relieve.
Often, relatives of drinkers confuse one of the exacerbations of chronic alcoholism - delirium delirium - with the usual state of a drunk person. This sign of delirium tremens in men and women is expressed in the fact that a person loses orientation in space, but behaves quietly and inconspicuously. Most often he just lies in bed, mutters something under his breath, and does not hear the calls of those around him. Speech is made up of fragments of words and even syllables. The patient makes specific movements, which are called “picking”, as if shaking off crumbs or collecting fine dust. A person may also pull a blanket, sheet, pillows from the bed, twirl, and the body trembles nervously. A person becomes lethargic and drowsy, alcoholic tremors appear, and then the alcoholic may fall into a coma. After delirium tremens of this type, severe neurological and psychosomatic disorders are common, and toxic encephalopathy develops.
Causes of alcoholic delirium
Alcohol delirium, as a rule, develops at the chronic stage of alcoholism after 5-7 years of constant drinking. But in some cases, if the addict’s condition is complicated by one or another mental illness, the symptoms of delirium tremens can make themselves felt at the 1st and 2nd stages of alcoholism. [2]
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The mechanism of development of the disease has not been fully established, but some experts believe that metabolic disorders in brain tissue caused by long-term heavy drinking play an important role in its development. When an addict abruptly stops drinking alcohol, withdrawal symptoms intensify significantly, accompanied by severe symptoms of delirium tremens, the consequences of which can cause serious harm to health.
People at risk:
- previously suffered traumatic brain injury,
- constantly consuming surrogate alcoholic drinks,
- have suffered severe psychological trauma,
- practicing dubious folk methods of abruptly quitting binge drinking.
Experts believe that “bad” heredity also increases the risk of developing delirium tremens. [2]
How to treat delirium tremens! How long do alcoholics live without treatment?
The most severe form of psychosis is delirium tremens. Severe alcoholic psychosis of this form is dangerous because changes in the functioning of body systems have become irreversible.
It usually develops in a person in stages. On the first stage, the patient’s consciousness is not disturbed, but inattention, talkativeness, and fussiness are recorded, which are sharply replaced by fear, apathy, and inattention. The person feels overwhelmed, depressed, and sleeps anxiously. These symptoms should already alert you.
The doctor decides what to do.
At this stage, antipsychotics, tranquilizers, and infusion therapy may be prescribed.
How to treat in women and men if the second stage occurs? Periods of recognition of loved ones in space are replaced by hallucinations, movements are sometimes uncoordinated. Dreams become nightmarish, heavy, the person groans, fights off the images that frighten him.
If symptoms intensify, immediately call a narcologist to your home for an initial consultation or urgently take the patient to a narcology clinic. The next stage may be a complete loss of awareness of what is happening, psychosomatic syndromes will appear: ataxia, diarrhea, sharp tachycardia, convulsive twitching of the limbs and epileptiform seizures. People who have experienced delirium tremens, as a rule, remember everything that happened to them, with the exception of moments in the third stage, when memory lapses begin. They are the ones who talk about serious malfunctions in the functioning of the brain.
Manifestation: how to prevent!
How does delirium tremens manifest itself in the third stage? The person does not recognize anyone at all, jumps up and moves chaotically around the room, screams, moans, grabs his head, hides under a bed made of large furnishings. He grabs knives and axes, tries to fight back, and sees imaginary characters of his hallucinations in those around him.
If delirium tremens sets in, in this state the person is dangerous to others, and you can safely call not only an ambulance, but also the police, so that a protocol can be drawn up, which will describe the patient’s actions. Based on protocols and written evidence in court, you can demand an examination and even eventually achieve compulsory treatment for alcoholism.
Delirium tremens syndromes are relieved through deep sleep, into which the person simply falls, but memories after delirium are well preserved.
Delirium tremens cannot be treated by placing a drip, the service to sober up at home will not help you, and delirium tremens is not just a withdrawal from alcohol: it is serious disturbances in the functioning of the entire body - only hospitalization in a hospital!!!
The most terrible consequences of delirium tremens can be:
- Coma, stuporous states.
- Encephalopathy.
- Edema and swelling of the brain.
If the productive symptoms of psychosis do not go away within a month or the duration of delirium tremens is two weeks or more, then intensive complex treatment is required, including spinal punctures, intravenous infusions, and active drug therapy.
Othello Desdemonovich
Another, and also almost male psychosis, is alcoholic delirium of jealousy. More precisely, the disease itself is called alcoholic paranoid, and depending on the content of delusional ideas, alcoholic paranoid proper (delusions of persecution) and alcoholic delusions of jealousy are distinguished. This is perhaps the most long-lasting psychosis. It develops gradually, against the background of gradual alcohol degradation. It most often occurs in older men.
First, attacks of jealousy, or, more precisely, ideas of adultery, visit the patient in a state of alcoholic intoxication. Having sobered up, he denies his own words and considers his suspicions groundless and his accusations unfounded.
Further more. Vague doubts begin to torment the father of the family and is in a state of hangover. The alienation that arises between spouses, including in the intimate sphere, adds fuel to the fire. The real reason for the discord lies in the husband's addiction to alcohol, and he believes that his wife has taken a lover. It is typical that the suspicions are of the most absurd nature; a 60-year-old wife may be jealous of the first-grader from the next apartment. Sometimes incestuous motives are also intertwined, and then their own sons are suspected of being “terrible.”
Over time, the patient develops a strong and unshakable confidence in his wife’s guilt, and a “lover” is appointed, most often someone younger from his immediate circle. And the meaning of life becomes the search for evidence of betrayal. The methods are far from Sherlock Holmesian, they are rather funny and pathetic. For example, sprinkling the floor in the corridor with sand or salt, leaving special marks in the keyhole, installing alarm systems in case of unauthorized entry of an opponent into the apartment.
The patient can hire a private detective, complain to the police, the prosecutor's office, the trade union and the animal welfare society. Visual and auditory hallucinations and illusions only strengthen the jealous man in his rightness: while talking on the phone, his wife certainly laughs at him, the sound of kisses is heard in the kitchen. To complete the picture, delusions of material damage are sometimes added (the wife spends money on her lover and debauchery) or witchcraft and poisoning (to free herself from her interfering husband).
Outbursts of anger and brutal violence are possible, primarily towards the wife, but an unsuspecting “lover” can also get it on occasion. Over time, the patient becomes so dangerous that he has to be isolated in a psychiatric hospital. There, in the absence of familiar stimuli, the symptoms gradually fade away. But if after discharge a person returns to alcohol, everything can start all over again.
The editors thank medical specialists for their assistance in preparing the material.
Alex Volgin
How to quickly recover from delirium tremens
Since treating delirium tremens at home is impossible, it is unreasonable to count on quick treatment at home. The problem is that the acute stage of abstinence itself affects processes in the functioning of the brain that often cannot be treated with conventional medications for alcoholism, since this will aggravate the condition. Moreover, these medications can cause irreparable harm. And procedures such as infusions, blood purification, spinal cord punctures cannot be carried out at home in principle: it is unrealistic to bring so much equipment into the house, even if funds allow.
Urgent assistance in Yekaterinburg
Remember all the symptoms and signs of delirium tremens and do not hope for a miracle. When a person begins to “see a squirrel,” it is not at all funny, and this is not an anecdotal situation. The person actually dies before your eyes. Do not allow such traumatic consequences of delirium tremens! Call a narcologist as soon as the first symptoms begin to appear. And after drug treatment, we continue to work with addiction to alcohol - this is the psychological part of complex treatment.
Treatment of alcoholic delirium
Delirium tremens is treated at a drug treatment clinic. The treatment regimen includes intensive detoxification of the body from ethanol breakdown products. Drug therapy is aimed at eliminating psychotic phenomena, normalizing metabolism, restoring organ functions, and preventing the development of persistent cognitive impairment.
During the detoxification process, the patient is prescribed intravenous saline solutions and vitamins. And to prevent the occurrence of disorders in brain function, the patient is prescribed nootropics.
How long treatment for delirium tremens lasts depends on the stage of the disease and the presence of other pathologies in the patient. But in any case, the period of stay in the drug treatment department of the hospital will be at least 2 weeks.
The addict is discharged from the hospital when his physical condition is restored. If the patient expresses a desire to fight the addiction, he will undergo long-term psychotherapy. Relatives must make every effort to convince the addict to fight alcoholism. Otherwise, the next time you binge, there is a risk of ending up in the hospital again with diagnosed delirium delirium.
