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Delirium Tremens: Assessment and Management
Sandeep Grover1, Abhishek Ghosh2
1Professor, Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Journal of Clinical and Experimental Hepatology
|December 20, 2018
Summary
Delirium Tremens (DT) is a severe alcohol withdrawal syndrome that can be fatal if not treated promptly. Management involves assessing withdrawal severity, delirium, and comorbidities, with benzodiazepines as the primary treatment.
Area of Science:
- Medical Science
- Neurology
- Addiction Medicine
Background:
- Delirium Tremens (DT) represents the most severe form of alcohol withdrawal.
- It affects nearly 2% of patients with alcohol dependence and can be life-threatening.
- DT is characterized by severe withdrawal symptoms, delirium, agitation, and hallucinations.
Purpose of the Study:
- To discuss clinical and laboratory parameters that predict Delirium Tremens.
- To outline the comprehensive assessment of DT, including withdrawal severity, delirium evaluation, and comorbidity screening.
- To review current treatment strategies for DT, including first-line and alternative therapies.
Main Methods:
- Review of clinical and laboratory parameters for DT prediction.
- Assessment protocols for alcohol withdrawal severity and delirium.
- Evaluation of common comorbidities, particularly liver disease.
- Analysis of treatment options, including benzodiazepines and alternative agents.
Main Results:
- DT prevalence is less than 1% in the general population and approximately 2% in alcohol-dependent individuals.
- Liver disease is a common comorbidity that complicates DT presentation, treatment, and outcomes.
- Benzodiazepines, specifically diazepam and lorazepam, are the primary treatment for DT.
- Phenobarbital, propofol, and dexmedetomidine are options for benzodiazepine-refractory cases.
Conclusions:
- Prompt and adequate management of Delirium Tremens is crucial to prevent mortality.
- Comprehensive assessment is necessary for effective DT treatment.
- Benzodiazepines are the cornerstone of DT therapy, with other agents available for refractory cases.
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