What are Delirium Tremens?

delirium tremens
Written By

Alcohol withdrawal syndrome is the name used to describe the symptoms that ensue when a person who is a heavy drinker tries to cut back or quit drinking “cold turkey.” Alcohol withdrawal symptoms can occur anywhere from a few hours to a few days after a person’s last drink and can last for weeks. Alcohol withdrawal symptoms range in severity from headaches and nausea to delirium tremens, a life-threatening condition.

What are Delirium Tremens?

Delirium tremens affects the mental and central nervous systems and can present as tremors, disorientation, visual or auditory hallucinations, trouble speaking or understanding and even seizures. Delirium tremens can be fatal if not treated.

The brain of a person with an alcohol use disorder works overtime to create more of the excitatory neurotransmitter glutamate to establish equilibrium. When someone who is a heavy drinker cuts back or stops drinking alcohol, the brain keeps producing extra glutamate as if they were still drinking, which leads to an overabundance of the neurotransmitter in the brain. This overabundance of glutamate will cause them to be highly excitable or anxious, an effect called “brain hyperexcitability.” This hyperexcitability is what creates the anxiety and mood swings that are attributed to alcohol withdrawal.

Common symptoms of alcohol withdrawal include two or more of the following:

  • Headaches
  • Shaking
  • Sweating
  • Nausea
  • Vomiting/diarrhea
  • Difficulty sleeping
  • Nightmares
  • Anxiety
  • Irritability
  • Rapid heartbeat

The signs of alcohol withdrawal can also be signs of delirium tremens, which involves abrupt and severe changes in a person’s mental state or nervous system. Delirium tremens typically begins six to 48 hours after the last alcoholic drink and can last anywhere from seven to 10 days.

struggling with alcoholism
Delirium tremens typically begins six to 48 hours after the last alcoholic drink.

Delerium Warning Signs

If you or someone you know has recently tried to detox from alcohol, it is important to know about the risk of developing delirium tremens. A person who has been drinking heavily for an extended period and then stops suddenly has a higher chance of going through delirium tremens in withdrawal, as well as any person who has been consuming alcohol for 10 years or longer.

Each person has a unique constitution and may present symptoms of delirium tremens differently but warning signs of delirium tremens can start within six hours of the last drink. These may be more mild including:

  • Stomach pain and gastrointestinal upset
  • Headaches
  • Rapid heartbeat
  • Insomnia or sleep issues

Within twelve hours these mild warning signs of delirium tremens can progress to alcohol hallucinosis and other more severe symptoms such as:

  • Excessive sweating
  • High blood pressure
  • Dissociation
  • Extreme anxiety and confusion
  • Trouble speaking or recalling words
  • Hallucinations (visual, tactile)
  • Unresponsiveness or hypersensitivity to external stimuli
  • Inability to concentrate
  • Short-term memory loss
  • Difficulty understanding
  • Fever
  • Seizures

Delirium tremens is a medical emergency, as it can be life-threatening. If you notice or experience any of these symptoms while going through alcohol withdrawal, seek immediate medical attention or call 911.

Alcoholism Help Near Me

When trying to detox from alcohol or cut back alcohol use, it is important to know about possible health complications related to alcohol withdrawal delirium. The safest way to detox from alcohol addiction or any substance is by going through a certified detox program that is medically monitored. Medical professionals and highly trained staff will ensure that you can safely come off the substance of abuse with doctors on call and nurses available in the case of any adverse reactions or health emergencies like delirium tremens. In addition to ensuring safety during detox, a program can help reduce the unpleasant side effects of withdrawal and offer greater comfort than trying to go off a substance alone.

DreamLife Recovery offers detox as the first step to beginning addiction treatment to prepare the body and mind for recovery. If you are worried about your alcohol use or the alcohol use of someone you care for, you might consider the full continuum of care provided by a treatment program at DreamLife. For more information about detox, contact us! Again, if you or someone you know is experiencing possible symptoms of delirium tremens, you should call 911 or seek immediate medical attention.


  1. “Delirium Tremens (DTs)” – Burns, Michael James, MD, FACEP, FACP, FIDSA; Chief Ed. Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM, MedScape; 6 November, 2020
  2. Mirijello A, D’Angelo C, Ferrulli A, Vassallo G, Antonelli M, Caputo F, Leggio L, Gasbarrini A, Addolorato G. Identification and management of alcohol withdrawal syndrome. Drugs. 2015 Mar;75(4):353-65. doi: 10.1007/s40265-015-0358-1. PMID: 25666543; PMCID: PMC4978420
  3. “Delirium tremens” – Dugdale III, David C., MD, David Zieve, MD, MHA, MedLine Plus; 10 January, 2019
  4. Rahman A, Paul M. Delirium Tremens. [Updated 2020 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482134/
  5. “Alcohol and Neurotransmitter Interactions” – Valenzuela, C. Fernando, MD, Ph.D., Alcohol Health and Research World, Vol. 21, No. 2, 1997