Addiction Medicine Made Easy | Fighting back against addiction Episode 42 - Delirium Tremens
Jan 6, 2023
Dive into the world of delirium tremens, a serious consequence of alcohol withdrawal. Discover how it impacts those with alcohol use disorder and the critical importance of early intervention. Learn about the mechanisms behind withdrawal symptoms, effective treatment strategies like benzodiazepines, and how to gauge severity using the CIWA-AR scale. The episode wraps up with practical advice for preventing recurrence and the importance of long-term abstinence. It’s a deep yet accessible look at a challenging issue.
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Alcohol Use Disorder Is Common And Risky
- Alcohol use disorder is extremely common, affecting ~20% of men and 10% of women in Western societies.
- About half with AUD have withdrawal symptoms and 3–5% of those will develop seizures or delirium tremens.
Biology And Time Course Of Withdrawal
- Chronic alcohol causes GABA down-regulation and glutamate up-regulation, creating excitatory imbalance when alcohol stops.
- Withdrawal typically begins within 8 hours, peaks at 72 hours, and improves by days 5–7.
Use CIWA‑AR To Guide Treatment
- Use the CIWA‑AR to assess severity: 0–7 mild, 8–15 moderate, >15 severe.
- Recognize severe scores as high risk for seizures and progression to delirium tremens.