Delirium tremens is a severe form of alcohol withdrawal that involves sudden and severe mental or neurological changes.
Causes

Delirium tremens can occur after a period of heavy alcohol drinking, especially when the person does not eat enough food.

It may also be triggered by head injury, infection, or illness in people with a history of heavy alcohol use.

It is most common in people who have a history of alcohol withdrawal. It is especially common in those who drink the equivalent of 4 - 5 pints of wine or 7 - 8 pints of beer (or 1 pint of "hard" alcohol) every day for several months. Delirium tremens also commonly affects those who have had a history of habitual alcohol use or alcoholism for more than 10 years.
Symptoms

Symptoms most commonly occur within 72 hours after the last drink, but may occur up to 7 - 10 days after the last drink. Symptoms may get worse rapidly, and can include:

* Body tremors
* Mental status changes
o Agitation, irritability
o Confusion, disorientation
o Decreased attention span
o Decreased mental status
+ Deep sleep that persists for a day or longer
+ Stupor, sleepiness, lethargy
+ Usually occurs after acute symptoms
o Delirium (severe, acute loss of mental functions)
o Excitement
o Fear
o Hallucinations (such as seeing or feeling things that are not present are most common)
o Highly sensitive to light, sound, touch
o Increased activity
o Mood changes rapidly
o Restlessness, excitement
* Seizures
o Most common in first 24 - 48 hours after last drink
o Most common in people with previous complications from alcohol withdrawal
o Usually generalized tonic-clonic seizures
* Symptoms of alcohol withdrawal
o Anxiety
o Depression
o Difficulty thinking clearly
o Fatigue
o Feeling jumpy or nervous
o Feeling shaky
o Headache, general, pulsating
o Insomnia (difficulty falling and staying asleep)
o Irritability or easily excited
o Loss of appetite
o Nausea
o Pale skin
o Palpitations (sensation of feeling the heart beat)
o Rapid emotional changes
o Sweating, especially the palms of the hands or the face
o Vomiting
The patient may need to be put into a sedated state for a week or more until withdrawal is complete. Benzodiazepine medications such as diazepam or lorazepam are often used. These drugs also help treat seizures, anxiety, and tremors.

Antipsychotic medications such as haloperidol may sometimes be necessary for persons with hallucinations.

Long-term preventive treatment should begin after the patient recovers from acute symptoms. This may involve a "drying out" period, in which no alcohol is allowed. Total and lifelong abstinence is recommended for most people who go through withdrawal. The person should receive treatment for alcohol use or alcoholism, including:

* Counseling
* Support groups (such as Alcoholics Anonymous)

Alcohol withdrawal develops because the brain adapts to the alcohol and cannot function well without the drug. Symptoms of withdrawal may include:

* Anxiety
* Confusion or seeing and hearing things that aren't there (hallucinations)
* Death (rarely)
* Increased blood pressure
* Loss of appetite, nausea, or vomiting
* Psychosis
* Raised temperature
* Rapid heart rate
* Restlessness or nervousness
* Seizures
* Tremors