Delirium tremens and its consequences. Are you deprived of your driver's license due to registration at a drug treatment center? there is a solution! How to recognize delirium tremens

Alcohol abuse causes many diseases that pose a threat to human life.

In this article, we will look at how delirium tremens manifests itself, its symptoms and consequences, and how long people with this diagnosis live.

Delirium tremens (delirium tremens) is the most common type of alcoholic psychosis How does “squirrel” appear? Many people mistakenly assume that this disease develops while drinking alcohol.

In reality, the symptoms characteristic of this disease appear in people during a sharp cessation of alcohol consumption, when leaving a state of binge drinking. The name "delirium" is translated from Latin as "shaking darkness." Using this term, the clinical picture characteristic of the disease is most accurately characterized.

The main symptoms of alcoholic delirium are tremors and clouding of consciousness.

When examining the question of what delirium tremens is, you should pay attention to the fact that the risk group includes people who have a significant history of drinking strong drinks. In only five percent of cases, symptoms of the disease are observed in people who previously drank alcohol in moderate doses. In the situation under consideration, the symptoms characteristic of a “squirrel” develop due to severe poisoning of internal organs with alcohol breakdown products.

The risk group susceptible to the development of acute psychosis syndrome due to alcohol consumption includes long-term alcoholics. Most often, this pathology is observed in people with the second or third stage of alcoholism. According to experts, delirium develops in people who abuse alcohol for more than ten years. Symptoms of the “squirrel” appear against the background of complete abstinence from alcohol after a binge that lasts several weeks. This disease manifests itself much less frequently in people who do not suffer from alcohol dependence.

The appearance of delirium tremens can be caused by the influence of factors such as:

1. Vivid emotional shock and being in constant stress.
2. Poisoning from low-quality alcoholic beverages.

In addition, there are certain factors that increase the risk of developing this disease. Such factors include the presence of traumatic brain injuries and diseases affecting the central nervous system. In addition, there is a risk of relapse in people who have previously experienced an episode of alcoholic delirium.

Why does delirium tremens occur?

Before we talk about what to do with delirium tremens at home, let's find out the reasons for the formation of this disease. Most often, the “squirrel” appears in sober people who have abruptly come out of a long binge. The pathology in question is a peculiar reaction of the human body to the exclusion of ethanol from metabolic processes.

As a result of prolonged consumption of alcohol, alcohol breakdown products are integrated into metabolic processes, against the background of which increased resistance to intoxication is observed. Drawing an analogy, this condition can be equated with the withdrawal of drug addicts in the absence of narcotic drugs.

Prolonged consumption of alcohol without a break leads to an oversaturation of the body with alcohol breakdown products. The probability of developing “squirrel” after a sharp exit from binge drinking is about fifty percent. Most often, delirium is influenced by factors such as mental and physical health problems.

Possible complications

After we have dealt with the question of what delirium delirium is, let's move on to the possible complications of this pathology. The danger of delirium tremens lies in the fact that after the attack is relieved, the patient exhibits various mental disorders. Despite the fact that complete recovery is quite often observed, there is a high probability of disability and death. Some patients experience various mental abnormalities in the presence of physical problems during the development of the syndrome. The severity of possible complications depends not only on the physical health of the person, but also on the methods used to break out of binge drinking. In addition, hereditary predisposition and the presence of mental disorders should be taken into account.

The consequences of “squirrel” can manifest themselves in the form of disruptions in the functioning of internal organs and the vascular system. In addition, there is a high probability of cerebral edema and disruption of alkaline, acid and water-salt balances in the body. There is also a risk of developing diseases such as:

• pneumonia;
• anemia;
• pancreatitis;
• psychosis that has a chronic form.

To reduce the risk of negative consequences, treatment for delirium should be started as early as possible. Timely treatment can significantly reduce the likelihood of complications.

Clinical picture

Symptoms of alcoholic delirium after binge drinking are expressed differently and depend on the duration of the binge. At a certain point, an alcoholic’s binge ends with the person developing an acute aversion to alcohol. Not only the desire, but also the physical need to drink drinks disappears. Along with this, the patient experiences sudden changes in mood. Joy and carelessness are replaced by anxiety and causeless fear. Developing depression and apathy can cause a suicide attempt.

The patient experiences tremors, sleep disturbances and causeless anxiety. Constant nightmares, one of the causes of insomnia and a feeling of constant fear for one’s own life. At a certain stage in the development of the disease, attacks of auditory and visual hallucinations are observed. Lack of medical attention at this stage can lead to more spectacular and realistic attacks. How many days delirium tremens lasts depends on both the physical and mental state of the patient. Some people experience bouts of hallucinations that last for several days.

The constant progression of these symptoms leads to the patient developing a fear of leaving the house. In this state, the alcoholic is dangerous not only for himself, but also for his immediate environment. In order to help the patient, you should call an ambulance as soon as possible and admit the alcoholic to a specialized clinic for treatment. The development of delirium tremens is accompanied by symptoms such as: attacks of hallucination, loss of orientation, attacks of insanity, a rapid increase in blood pressure and body temperature. To the listed symptoms should be added a feeling of anxiety, sleep problems, panic attacks and tremors of the limbs.

Varieties of manifestations of alcoholic delirium

Before we talk about treatment methods, let's look at how delirium manifests itself in various forms. A typical syndrome is characterized by a gradual onset and sequential development of symptoms. The lucid type of fever has an acute onset and differs from other forms of the disease in the absence of attacks of hallucinations. Most often, patients with this type of disease experience panic attacks, an unreasonable feeling of fear and problems with coordination.

Signs of delirium tremens in male alcoholics can be expressed by fragmentary delirium and fragmentary attacks of hallucination. These symptoms are characteristic of the abortive form of the disease. The key feature of this type of disease is that the patient has a chance of full recovery, without catastrophic consequences for the psyche.

But here it should be mentioned that delay in providing medical care can lead to the transition of the disease to more complex stages.

The muttering form of the disease is one of the complications of other types of pathology in question. During attacks of confusion, problems with orientation in space and somatovegetative disorders are observed. The patient constantly talks to himself and repeats the same sequence of actions. This form of the disease is one of the signs of cerebral edema and possible death. With an atypical type of pathology, symptoms similar to schizophrenia are observed. This form of “squirrel” is most often a relapse of a previously suffered syndrome.

Stages of disease development

The effectiveness and result of the therapy directly depend on the stage of development of the disease. Experts identify three main stages in the development of the disease. With threatening fever, the symptoms of the disease are more characteristic of withdrawal syndrome. The clinical picture characteristic of delirium itself at this stage is weakly expressed. The alcoholic is still aware of his personality, and all the symptoms of the disease manifest themselves only as a form of disorientation in time and space. Body temperature rarely exceeds normal values. This stage of the disease is completely reversible. It should also be noted that the disease can disappear on its own, without the intervention of specialists.

The completed stage of the disease has its own distinctive features. All the symptoms characteristic of the “squirrel” are very pronounced. The patient experiences: increased blood pressure, rapid breathing, attacks of shortness of breath, delirium and hallucinations. At this stage of the disease, the patient needs emergency medical care, as there is a high probability of developing a more dangerous form of the disease. The life-threatening stage of the patient is characterized by an increase in the severity of somatic symptoms.

Lethargy, decreased response to external stimuli and a sharp drop in blood pressure only worsen the situation. Depression of consciousness can lead to coma and subsequent death. Quite often, patients at this stage experience irreversible damage to internal organs. Decompensation most often ends in the death of the patient.

Treatment methods

If you are interested in how to treat delirium tremens at home, then you should say in advance that self-treatment of this disease is impossible. Attempts to independently provide assistance to a patient can cause an unexpected reaction from the body and result in death.

This is why the treatment of delirium tremens should be carried out in a clinical setting by an experienced specialist. In order to relieve the syndrome, doctors detoxify the body and normalize the functioning of internal organs. Comprehensive treatment of delirium tremens includes the use of nootropics, intravenous injections of glucose, saline solutions and other medications. In addition, the method of formed diuresis, plasmapheresis and vitamin therapy are used.

Prolonged abuse of alcoholic beverages leads to the development of delirium tremens, or, speaking in the language of science, to delirium tremens. The consequences of this condition, as well as its symptoms, can be dangerous for humans. Therefore, you should know what to do in such cases and how you can help him.

What it is

Before figuring out what to do when delirium tremens begins, you should find out what it is. This disease belongs to acute mental disorders and occurs at stages 2-3 of chronic alcoholism during the period of cessation of another binge. It is characterized by the presence of delusions, groundless fear, visual or auditory hallucinations against the background of somatic manifestations. The patient has an aversion to alcohol during this period and stops drinking alcohol. Psychosis often develops rapidly, mainly in the evening and at night.

Causes

The only reason for the development of delirium tremens (popularly “squirrels”) is prolonged, long-term consumption of alcohol, accompanied by ongoing intoxication of the body. As a result, a disorder of mental and electro-biochemical processes in the brain occurs. However, delirium tremens can develop not only in an avid alcoholic, but also in a person who does not suffer from addiction. In this case, the disorder can be provoked by:

• significant doses of alcohol;
• consumption of alcohol-containing surrogate products;
• simultaneous use of different psychoactive drugs;
• drinking alcohol by a person suffering from mental illness.

The chronic form of alcoholism is a serious illness accompanied by regular use of substances containing alcohol, with the emergence of psychophysical stable dependence. With this disease, irreversible changes occur in the internal organs. We can say that the process of decomposition of the body and personality in this case is incurable.

Who is at risk

The second and third stages of alcoholism, in which delirium tremens can develop, often occur after 5-6 years of frequent consumption of intoxicating products. For women, this period begins earlier (after 3 years) due to the fact that they turn into alcoholics much faster than men. Delirium alcoholism most often affects people over 40 years of age. By this point, life has managed to take a fair toll on the already frayed nerves of an alcoholic, which makes his psyche defenseless against acute psychosis. In addition, people at risk include:

• survivors of inflammatory diseases of the brain (meningitis, encephalitis);
• those who received TBI (traumatic brain injury);
• who have previously been diagnosed with single hallucinations;
• suffering from chronic diseases in the period of exacerbation.

Forms

Delirium tremens, depending on the severity of the consequences, is divided into several forms:

1. Classic. Begins in the midst of withdrawal symptoms. Lasts 3-5 days, sometimes 7-10 days. The attack ends with apathy and a decrease in emotional background.
2. Lucid, in which the patient’s feelings of fear and anxiety increase, and coordination of movements is impaired. There are no delusions or hallucinations.
3. Auditory, with a predominance of verbal illusions.
4. Abortive, in which fictitious auditory and visual images appear in fragments. Delusional thoughts are not yet fully formed, anxiety is growing.
5. Fantastic, with clouding of consciousness, disorder of self-awareness, depressive and manic affect.
6. Heavy. It occurs against a background of weakening of the body and has an extremely unfavorable prognosis. It can develop into Gaye-Wernicke syndrome and provoke organic changes.

Main symptoms

If a loved one has developed delirium tremens, the symptoms of which depend on the general condition of the body, you need to know what to do in this case and how to properly provide qualified assistance. The provocateur of acute psychosis is abstinence syndrome (withdrawal syndrome), quitting a binge, or reducing the consumed portions of strong drinks. An alcoholic experiences a narrowing of consciousness, during which hallucinations and sensory sensations arise that are directly related to their content. At the same time, self-awareness is preserved, and motor activity increases.

Severe symptoms of alcoholic delirium are characterized by the following hallucinations:

• Auditory. The patient clearly hears voices that out of nowhere ask for help or are aggressive. In such a situation, he may panic, experience fear, and seek refuge from imaginary persecution.
• Visual. In the darkened consciousness, disgusting images begin to form (insects, rats, snakes, devils, monsters) that are watching the patient from everywhere and are going to harm him.
• Tactile. Visual hallucinations begin to turn into tangible, terrible creatures that crawl over the body, sting, and cause pain to the unfortunate person.
• Olfactory. Ghosts that appear to a patient can emit extremely repulsive odors.

If a husband or wife is an avid drinker, then his other half or close relatives should be prepared for the development of delirium tremens. Its main external sign is a change in the alcoholic’s facial expressions and the appearance of strange, inappropriate grimaces. Additional somatic symptoms of this mental disorder include:

• sleep disturbance, insomnia, nightmares;
• sudden mood swings;
• tachycardia;
• facial redness;
• tremor of the limbs and body;
• diarrhea syndrome;
• changes in blood pressure;
• chills, fever.

In addition, the composition of the blood changes, markers of inflammation are present in it, the amount of daily diuresis decreases, and signs of dehydration develop. In women, the symptoms of delirium are more pronounced. The main harbinger of impending delirium tremens is a prolonged depressive state into which an alcoholic falls. In addition, the development of the disease is indicated by:

• aggression towards others due to inability to sleep;
• nervousness and fears;
• development of inadequate liveliness and manic hyperexcitability;
• sudden change of mood.

Stages of development of delirium delirium

Each stage of the disease is accompanied by special symptoms:

1. At the first stage, precursors appear that resemble withdrawal symptoms: dizziness, weakness, lethargy, extreme thirst, loss of appetite, anxiety, sweating, increased blood pressure, tremor of the tongue and hands, and a strong desire to drink. A person is tormented by memories from the past, talkativeness, agitation, nervousness, fear of light and noise are observed. All symptoms increase in the evening.
2. At the second stage, the patient experiences visual visions, the images of which are made up of surrounding objects: drawings on wallpaper, cracks on the walls and ceiling, mosaics of tiles, etc. The mood changes sharply, rare moments of clarity of consciousness are noted, but basically orientation in time and space is lost. Sleep becomes superficial and sensitive. A person shudders in his sleep, twitches, screams.
3. The third stage is accompanied by the appearance of hallucinations. They frighten the patient, forcing him to run away, hide, and defend himself. He may experience a sensation of foreign objects in the body and try to get them out. Delirium is added, accompanied by speech and motor hyperexcitability. There is almost no sleep. Disorientation in time persists, although the person is aware of who he is and can name his name, profession, age, etc. Delirium often ends at this stage after a long deep sleep, into which the unfortunate person is induced with the help of medications.
4. The fourth stage is rarely recorded. Professional and mumbling delirium appear. The patient becomes detached from reality, obsessive movements and meaningless muttering begin. Against the background of decompensation of the cardiac and respiratory systems, coma may develop.

How long does it last after drinking?

People whose close relatives have experienced delirium tremens want to know how long they live after it develops, and how long the psychosis lasts. Hallucinations haunt the patient throughout the binge after delirium has made itself felt. The post-drinking stage of hallucinations can take place within 3-6 days. With timely medical care, the period of delirium can be shortened or even prevented. The following durations of hallucinosis are distinguished:

• Subacute. Lasts from one month to six months. Characterized by the presence of vocal hallucinations, depression, and persecution mania.
• Chronic. Lasts from six months to several years. Accompanied by verbal and tactile hallucinations, delusions, and delusions of persecution.

Therapeutic measures

Alcoholic delirium requires urgent hospitalization of the patient. In a psychiatric (or drug treatment) hospital, they determine how to treat delirium tremens with medication, and whether it is necessary to involve a psychologist or psychotherapist in general therapy. The following methods help return an addicted person to normal life:

• Detoxification. A drip infusion of Hemodez and glucose is carried out, and hemosorption is used. This allows you to remove ethanol residues and its breakdown products from the blood and tissues.
• Anticonvulsants (for example, Carbamazepine), medications that suppress psychosis, and drugs that prevent the development of cerebral edema (1% Lasix solution) are used. Cordamin and Korglykon are capable of supporting cardiac activity.
• Tranquilizers and barbiturates are used - tablets that reduce tension and prevent further seizures (Phenobarbital, Phenazepam, Elenium).
• Sedative neuroleptics (Haloperidol) and neuroprotectors (Cytoflavin, Glycine, Cardionate) are prescribed.

For severe delirium, benzodiazepines are used to stop nervous excitement and eliminate muscle contractions.

Treatment at home

To prevent the development of serious consequences, it is necessary to treat delirium tremens at home before the ambulance arrives. This will significantly increase the patient's chances of survival. Necessary:

• call an ambulance;
• lay the patient on the bed and tie his arms/legs to immobilize him in case of violent aggression;
• remove children, pregnant women, and elderly people from the premises;
• hide piercing and cutting objects;
• close windows and doors, leave the vents open for fresh air;
• do not ask in detail about hallucinations;
• dim the bright lights, turn off the TV/radio;
• apply a cold compress to the head and change it as needed;
• try to calm the patient down, talk to him calmly and evenly;
• during a convulsive seizure, try to soften the fall, lay the victim on the floor, turn his head to the side so that it does not hit the corners. Inserting any objects into your mouth, especially your own fingers, is strictly prohibited;
• if the patient does not feel nauseous, provide plenty of fluids, offer herbal infusions prepared according to folk recipes, rosehip infusion, weak sweet tea;
• if possible, provide a cold shower;
• if a person falls asleep, turn him on his side or stomach and do not wake him up until the medical team arrives.

The disease can be treated at home only if its manifestations are mild and under the supervision of a doctor. It is necessary to give the person a good night's sleep and provide a balanced diet. Contrast showers and walks in the fresh air help. An alcoholic needs to periodically visit the hospital, learn to live and deal with stress without alcohol. You cannot blame him, openly hate him, since feelings of depression and guilt can cause another desire to drink and harm yourself.

Possible complications and consequences

Delirium tremens has pronounced symptoms and can lead to dangerous consequences, especially if treated at home without medical assistance. The saddest outcome of the disease is the death of an alcoholic. This happens in 5-10% of cases. In addition, complications such as:

• dysfunction of the brain;
• acute renal failure;
• chronic, anxiety, nervousness;
• weakened immunity;
• loss of visual acuity and hearing.

Severe signs of delirium tremens may go away on their own after binge drinking in a few days, if they occur for the first time, and the person then refuses alcoholic beverages. With each subsequent time, the disease lasts longer, and its symptoms may persist for 1-2 weeks. It is no longer possible to cope with the disorder on your own. The patient should be admitted to the hospital for treatment, to prevent suicide and to isolate him from others.

Delirium tremens hits all organs and systems of the body. The most damaged are the kidneys, liver, heart, and brain. Possible consequences of an advanced form of the disease include:

• sharp deterioration in general condition;
• increase in body temperature, hypertension;
• dehydration, loss of motor functions, abnormal heart rhythm;
• chills, hyperhidrosis, yellowing of the sclera of the eyes, pallor or redness of the face;
• partial memory loss;
• renal edema;
• ischemia;
• intestinal paresis;
• intoxication, fatty hepatosis;
• microbleeds in the brain;
• acute alcoholic psychosis.

How to avoid developing delirium tremens

The following preventive measures will help you avoid delirium tremens:

• awareness of alcohol dependence;
• if you can’t completely give it up, you should set and control the amount you drink;
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Chronic alcoholism affects not only the alcoholic, but also his family. In the last stages of the disease, symptoms of alcoholic delirium are often observed, which is called “ delirium tremens "or "squirrel".

This is a dangerous mental disorder that drives a person crazy. It is important to stop the development of pathology in time and take treatment measures.

What it is

Alcohol delirium is a severe mental disorder that manifests itself in the form of unreasonable aggression, loss of time and space, and severe agitation.

Delirium tremens got its name for a reason. During it, the alcoholic the temperature rises sharply and the face becomes pale.

The person experiences hallucinations of a tactile, auditory and visual nature. Often this condition leads to suicide.

Protracted delirium delirium develops due to a sudden refusal of strong drinks after a drunken state - at least 7 days. If the body that is accustomed to alcohol stops receiving ethyl alcohol, a metabolic disorder occurs in the brain, which causes excitation of the central nervous system, all of which affects the psyche.

In some cases, the squirrel overtakes healthy people after drinking low-quality alcoholic beverages or taking psychotropic drugs.

According to statistics, delirium tremens most often occurs in people over forty years of age, mainly in women.

At risk are individuals who have suffered a TBI or serious inflammatory diseases of the nervous system, as well as those who have previously encountered a similar mental disorder or have acute chronic infections.

ICD-10 code

F05– delirium not associated with psychoactive drugs and alcohol.

F10.4– withdrawal state with delirium.

Symptoms and signs

Most often, signs of delirium tremens in alcoholic men are noticed two or three days after drinking.

Delirium tremens usually occurs in people who have been addicted for more than five years. In women, it manifests itself already in the third year of alcoholism.

There are three phases of delirium tremens, which have specific symptoms and consequences:

1. Korsakov's psychosis . Expressed in unexpected mood swings, memory problems, sleep disturbances.
2. Delirium . Manifests itself in the form of depression, unmotivated aggression, and the desire to die.
3. Severe form . It is characterized by severe pain in the head, speech disorders, and pathologies of internal organs.

Symptoms of the disorder increase as dependence on alcohol increases.

Alcoholic delirium, the clinical manifestations of which are similar to those, is accompanied by other signs:

• vomiting, convulsions;
• tremor of the limbs;
• dizziness;
• increased blood pressure;
• lack of appetite;
• profuse sweating;
• skin redness;
• yellowing of the whites of the eyes.

A person is worried, fears for no reason, a premonition of danger, frequent awakenings at night.

A person can shake off invisible insects, hide from haunting visions, and talk to a non-existent interlocutor. At the peak of the development of psychosis, scenes with fantastic heroes and animals, aliens emerge in the imagination. Symptoms of the disorder are especially pronounced at night. With the arrival of dawn, the severity of hallucinations decreases. Trying to escape from danger, patients jump out of windows and get hit by a car.

How long does delirium tremens last after drinking?

If we talk about the duration of delirium tremens after a binge, it is worth noting that a similar condition is observed throughout two, three and even five days .

It all depends on several factors:

• duration of the disease;
• duration of drunkenness;
• volume of alcohol consumed;
• the presence of mental and somatic diseases.

The maximum duration of delirium tremens is two or three weeks. In this case, urgent treatment in a hospital is required, otherwise the situation can lead to complex brain damage and death.

What to do if you have delirium tremens

If the patient is rowdy and behaves inappropriately, the following manipulations must be done:

1. You should lay him on the bed and, if necessary, tie him up.
2. It is important to protect the individual and others from harm.
3. It is necessary to provide him with plenty of fluids.
4. You can reduce the temperature with a contrast shower and a cold compress.
5. We need to call an ambulance.

First of all, doctors give a person Diphenhydramine , Barbamil or enter Diazepam intramuscularly. After this, he is hospitalized for treatment.

It is worth considering that self-treatment of withdrawal symptoms often leads to unpredictable consequences. Therefore, experts advise seeking help from doctors at the first manifestations of “squirrel”.

Treatment

Treatment in the clinic is carried out taking into account the general state of health, contraindications, and other pathologies. The duration of therapy depends on the severity of the disease.

Therapy

Treatment in the hospital includes a number of activities:

1. Normalization of the functioning of the cardiovascular system and other organs. Brain edema is removed with Lasix solution and vitamins; intravenous glucose and liquid administration of Hemodezom are used to filter the kidneys.
2. Restoring normal metabolism. To improve metabolism, Reopolycluk is used.
3. Restoring mental well-being. Eliminate aggression and improve the functioning of the nervous system with the help of a solution of Sibazon, Seduxin.

At home

You can fight delirium tremens yourself only if mild manifestations disorders. It is necessary to provide the patient with adequate sleep and a balanced diet.

• Alternating warm and cold showers and walks in nature help a lot.
• It is necessary to help a patient with alcoholism cope with stress and guilt.
• He shouldn't drink alcohol.

Forbidden give drugs to a patient without the doctor’s knowledge.

You cannot shout at him, scold him or raise your hand to him. It is important to understand that a person does not adequately perceive the surrounding reality.

Alcoholic delirium is treated at home with folk remedies. These include:

• a decoction of bay leaf and lovage root;
• tincture of wormwood and centaury;
• inhalation over birch smoke;
• hellebore tincture.

Natural helps a lot honey . It is given to the patient six teaspoons three times an hour. Then they take a break of two hours and repeat the course again.

Predictions and consequences

Delirium tremens often has complications. Then the stay in the hospital is prolonged.

The disease will be treated together with other pathologies. If a patient has pneumonia, pancreatitis, cirrhosis, coronary artery disease, tuberculosis or other serious health problems, he will be transferred to the appropriate department.

Its consequences depend on several factors:

• time to see a doctor;
• therapy literacy;
• presence of other diseases;
• the patient's lifestyle after discharge.

Complications occur with any form of delirium. With high-quality treatment of mild and moderate stages of the disorder, the life and health of the patient will not be threatened.

A neglected form can cause unpleasant consequences. Among them:

• mental disorders;
• chronic psychosis;
• amnesia;
• chronic liver pathologies;
• kidney disease;
• ischemia;
• renal edema.

These complications are largely associated with alcohol intoxication.

If a person stops drinking alcoholic beverages, the risk of delirium tremens will be minimized. When conducting self-treatment, you must consult a doctor to avoid serious consequences.

Alcoholism belongs to a group of complex diseases that harm internal organs, the human psyche and cause personality degradation. After uncontrolled drinking, an alcoholic often develops the hardest a complication called in the medical field alcoholic delirium or delirium tremens, the consequences of which are very dangerous for human life.

The disease is a common type of alcoholic psychosis. It is expressed in the complete inadequacy of the patient’s behavior during the break of a severe binge. Symptoms are varied and individual for each patient. At the first signs of delirium tremens, you should contact a narcologist for help, as the consequences may sad not so much for the alcoholic, but for those around him.

Causes and symptoms of delirium tremens after binge drinking

Delirium tremens is a clouding of consciousness, which is accompanied by fear, hallucinations, delirium and extreme agitation. Most often, the condition develops against the background of withdrawal syndrome, although it can occur not only in binge alcoholics, but also in those who do not suffer from alcoholism. harmful human attachments.

The main reasons for the appearance of delirium tremens:

• large dose of alcohol taken;
• consumption of surrogate drinks;
• drinking alcohol by a mentally ill person;
• use of psychotropic substances simultaneously with alcohol.

Most often, the disease occurs in chronic alcoholics who already have physical and mental dependence on ethanol products and irreversible changes in psyche, internal organs. The main signs of mental disorders that threaten to result in a state of delirium tremens are expressed as follows:

• disdain for the possible consequences of heavy drinking;
• irresistible craving for alcohol;
• lack of control over the use of alcohol;
• the occurrence of withdrawal syndrome;
• lack of interest in the outside world;
• alcohol tolerance;
• Constant thoughts about wanting to drink.

Alcoholic delirium occurs on latest stages of alcoholism. It can be provoked by heavy libations, prolonged drinking, infectious diseases, skull injuries, aggravated chronic pathologies, and surgical intervention.

The symptoms of delirium tremens are characterized by a variety of manifestations:

• delirium, incoherent speech, absurd conversations;
• auditory and visual hallucinations;
• headache;
• tremors of the limbs, in severe cases tremors of the whole body;
• temperature increase;
• severe chills.

In the visions of the patient visit fantastic monsters, devils, huge beetles and spiders that threaten his life. Often such hallucinations end in death - the psyche cannot stand it, and the patient can cause damage to himself that is incompatible with life.

Delirium tremens is characterized by the development of the disease during the period when there is a sharp break in the binge. Psychosis usually begins three to six days after the cessation of binge drinking. However, there are times when the “squirrel” visits the patient during heavy libations.

What consequences may appear after delirium tremens depends on the characteristics of the course and duration of delirium, the speed of treatment emergency care, the patient’s age and the presence of concomitant pathologies.

Consequences after delirium tremens for humans

Manifestations of alcoholic delirium negatively affect the functioning of human internal organs and systems. The consequences after delirium tremens develop according to different scenarios - from complete recovery to fatal outcome.

Common consequences are:

• chronic state of psychosis;
• amnesia;
• cardiac rhythm disturbances;
• deterioration of the circulatory system;
• severe liver disease;
• renal failure;
• swelling of the meninges.

The most severe consequences of delirium tremens with impaired brain function. They often lead to coma or death of the patient. Death may also be caused by suicide or heavy disturbances in the functioning of vital organs. Incomplete recovery is expressed in residual effects of organic and amnestic syndromes.

With organic psychosyndrome, a decrease in memory, intelligence, and the manifestation of states of insanity and asthenic phenomena are formed. a person gets tired quickly. becomes capricious, tearful, and incapable of prolonged mental activity.

With amnestic syndrome, memory for current events is reduced, the presence of false memories, loss of orientation in space and time. At the same time, distant memory remains good, and events from a week ago and yesterday are completely forgotten.

If a loved one has already had manifestations of alcoholic psychosis, delirium tremens may recur more than once. As a rule, each subsequent attack becomes more severe, so it is very important timely seeking medical help and further treatment of alcoholism. Complete relief from attacks depends on the patient’s desire to be cured, his health, and the degree of damage to the body from alcohol toxins. Patients who are lucky enough to defeat the visiting “squirrel” most often show the desire to completely get rid of from alcoholism, because they do not want to repeat the sad experience. This is greatly facilitated by the realization that a new attack will become much more intense, and the consequences of delirium tremens after binge drinking will become fatal.

What consequences of delirium tremens require immediate attention?

Situations when others have no idea what to do when symptoms of delirium appear in a loved one occur all the time. A person in need of emergency medical intervention often remains defenseless and may die if competent assistance is not provided on time.

To alleviate the suffering of a patient in a state of alcoholic delirium, the first thing you should do is call a team of narcologists as soon as possible. While waiting for the doctors to arrive, you need to do the following:

• put the patient in bed, if there is resistance, use force to protect him and his loved ones from possible harm injuries;
• put cold on your head, you can cool your head under ice water;
• Give as much water as possible to prevent dehydration;
• give a strong sedative or sleeping pill;
• Constantly keep the patient’s condition under observation, try not to make noise, and communicate calmly.

Treatment of alcoholic delirium is carried out only within the walls of a drug treatment clinic. Only a professional specialist with experience will be able to understand what consequences of delirium tremens threaten the patient in each individual case and what needs to be done to maximum quickly and effectively remove him from a threatening state.

Removing a patient from delirium tremens in a hospital setting is carried out in several steps:

• Nervous overexcitation is relieved, sleep is normalized;
• the body is cleansed of alcohol toxins;
• the water-salt balance is restored, the body replenished vitamins and minerals.

Psychotropic drugs, detoxification medications, and medications that restore the functions of internal organs are used for therapy. The procedures quickly alleviate the patient’s condition and relieve the symptoms of alcoholic delirium.

After emergency measures, a course of treatment is required to avoid sad consequences and complications. The therapeutic program includes restoration of the hematopoietic and respiratory systems, proper functioning kidneys, liver. Preventive measures are being taken to prevent or eliminate edema of the brain and lungs, and treatment of chronic pathologies.

Patients with delirium tremens are often mistakenly associated with aggressive and angry people. Meanwhile, a sick person sometimes, on the contrary, becomes cheerful and positive, but it is necessary to hospitalize him in this case as well. The situation during the course of the disease may change instantly.

) is an acute psychosis that develops against the background of prolonged use of alcoholic beverages and belongs to the group of metal-alcohol psychoses. It occurs with disturbances of consciousness, tactile, auditory, visual hallucinations or illusions.

Delirium tremens is a complication of alcoholism

Delirium tremens is the most commonly observed alcoholic psychosis. In most cases, it first occurs in patients suffering from stage II or III alcoholism, i.e., no earlier than 8-10 years from the moment they begin to regularly drink alcohol.

In very rare cases, delirium tremens develops in people who do not suffer from alcoholism after a significant alcoholic libation.

In contrast to the popular belief among ordinary people, signs of delirium tremens are never observed in persons who are acutely intoxicated, but develop only a few days after the abrupt end of the binge.

Symptoms of delirium tremens vary widely. In some cases, patients become aggressive, and in others, on the contrary, they become friendly and strive to perform noble actions for the benefit of loved ones. The transition from one condition to another can occur quickly, so patients with delirium tremens should never be considered safe and left without medical care.

Delirium tremens is a life-threatening condition for the patient. Without appropriate treatment, approximately 10% of patients die from complications from internal organs, accidents or suicide.

Causes and risk factors

The only reason for the development of delirium tremens is the abuse of alcoholic beverages that lasts for many years. Factors that increase the risk of alcohol-induced delirium include:

• consumption of low-quality alcohol (pharmacological preparations and technical liquids containing alcohol and its surrogates);
• long drinking bouts;
• expression of pathological changes in internal organs, primarily in the liver;
• brain diseases and history.

The pathological mechanism of the development of delirium tremens has not yet been fully studied. It is assumed that the main role in the occurrence of acute psychosis is played by metabolic disorders and long-term chronic intoxication of brain tissue.

Forms of the disease

Depending on the characteristics of the clinical course, several forms of delirium tremens are distinguished:

1. Typical or classic. As the disease progresses, it passes through certain stages, and the clinical picture develops gradually.
2. Lucid. Psychosis occurs acutely. Patients experience a feeling of fear and anxiety, and impaired coordination of movements. There are no hallucinations or delusions.
3. Abortive. Hallucinations are fragmentary. Delusional ideas are not fully formed and are fragmentary. Anxiety is very pronounced.
4. Professional. Patients perform only stereotypical, repetitive movements associated with dressing, undressing, and performing professional duties; the behavior is automated. Accompanied by amnesia.
5. Mussitating. It is the outcome of the professional version of delirium tremens. The patient experiences severe clouding of consciousness, movement disorders, and severe somatovegetative disorders.
6. Atypical. The clinical picture has many similarities with schizophrenia. Develops in patients who have previously suffered one or more episodes of delirium tremens.

The consequences of delirium tremens can be memory impairment of varying degrees of severity, as well as the formation of a psychoorganic syndrome, severe damage to internal organs.

Stages of delirium tremens

During classic delirium tremens there are three stages:

1. Initial. The patient has mood disorders. The psycho-emotional state changes quickly and unmotivatedly, an elevated and cheerful mood is replaced by worry and anxiety, and after a while the patient again falls into an anxious state. These mood swings, combined with active movements, facial expressions and speech, create the impression of nervousness. Superficial sleep, accompanied by frightening dreams and frequent awakenings. Fragmentary visual and auditory hallucinations may occur. Patients tell others about the memories and vivid images that pop up in their minds.
2. Hypnagogic hallucinations. The appearance of hallucinations at the moment of falling asleep is typical. Sleep remains superficial, with nightmares. When patients wake up, they cannot distinguish reality from a dream. During the day they are haunted by visual hallucinations.
3. Insomnia. As the disease progresses to this stage, sleep disorders develop. Hallucinations become almost constant and very vivid. Patients “see” fantastic monsters, large or small animals. Tactile hallucinations are often observed (sensation of small foreign bodies in the oral cavity, insects crawling over the body, etc.). Auditory hallucinations include threatening or judgmental voices.

Symptoms of delirium tremens

The classic form of delirium tremens begins to develop gradually. The course of the disease is often continuous, but in 10% of patients it is paroxysmal in nature: several attacks occur, separated by light intervals that last less than 24 hours. After a long sleep, delirium tremens ends acutely. Much less often, symptoms of psychosis regress gradually. The duration of the classic form of delirium tremens is usually 2–8 days. In approximately 5% of cases, the disease takes a protracted course.

In very rare cases, delirium tremens develops in people who do not suffer from alcoholism after a significant alcoholic libation.

In the prodromal period, which begins with the abrupt end of the binge and lasts until a clear clinical picture of the disease appears, patients experience sleep disturbances (frequent night and early awakenings, nightmares, heavy dreams). Waking up in the morning, they note a loss of strength and severe weakness. The mood is low. In the first 48 hours from the end of the binge, epileptiform abortive seizures may occur. In some cases, the development of delirium tremens is preceded by short-term auditory hallucinations. Sometimes the prodromal period is so weakly expressed that it goes unnoticed by the patient himself and those around him.

At the height of the development of psychosis, colorful scenes with fantastic or real animals, aliens, and fairy-tale characters appear in the imagination of patients. Patients cease to adequately perceive the space and time around them; it seems to them that the passage of time is either accelerating or slowing down, and the surrounding objects are in constant motion. Patients become restless, try to hide or escape, shake “insects” from their clothes, and conduct dialogues and arguments with invisible interlocutors.

Patients with delirium tremens are characterized by increased suggestibility. They can, for example, be convinced that they hear music from a switched-off radio or see text on a sheet of completely white paper.

The condition of patients worsens at night; with the onset of dawn, the severity of hallucinations decreases and a light gap is formed. A decrease in hallucinations is also noted when the patient is involved in an active dialogue.

After the patient manages to fall asleep and sleep for a long time, the symptoms of delirium tremens stop abruptly. Less commonly, recovery from a state of acute psychosis occurs gradually.

After the attack has stopped, patients do not remember or have difficulty remembering real events from their lives that occurred during the period of illness, but at the same time they clearly remember their hallucinations. They experience significant mood swings and asthenia develops. Men often develop mild hypomania, and women often develop depressive states.

Other forms of delirium tremens are observed much less frequently than classic ones.

With the professional form of delirium tremens, the condition of patients gradually becomes more severe. They experience monotonous, increasing motor and affective disorders.

The clinical picture of delirium tremens includes the following symptoms:

• incoherent speech;
• rudimentary simple movements (grasping, robbing);
• dullness of heart sounds;
• rapid breathing;
• significant fluctuations in blood pressure;
• severe tremor;
• changes in muscle tone;
• impaired coordination of movements.

Treatment of delirium tremens

Patients with delirium tremens must be hospitalized in a psychiatric or drug treatment clinic. They undergo detoxification therapy (plasmapheresis, forced diuresis, intravenous administration of saline solutions and glucose), as well as correction of impaired vital functions. Prescription of potassium supplements, nootropics and vitamins is indicated.

Delirium tremens is a life-threatening condition for the patient. Without appropriate treatment, approximately 10% of patients die from complications from internal organs, accidents or suicide.

Psychotropic drugs in the treatment of delirium tremens are ineffective, so they are used extremely rarely and only in the presence of strict indications (psychomotor agitation, severe anxiety, prolonged insomnia). Psychotropic drugs are contraindicated in the professional and persistent form of the disease.

Possible complications and consequences of delirium tremens

The consequences of delirium tremens can be memory impairment of varying degrees of severity, as well as the formation of a psychoorganic syndrome, severe damage to internal organs. An altered state of consciousness with preserved and sometimes increased motor activity makes a patient with delirium tremens dangerous both for others and for himself.

Forecast

The prognosis for delirium tremens is determined by the timeliness of starting therapy and the form of the disease. In most cases, the classic form of delirium tremens ends in recovery. With severe psychosis, the risk of death increases. Prognostically unfavorable signs are:

• respiratory rate over 48 breaths per minute;
• urinary and fecal incontinence;
• muscle twitching;
• deep disturbances of consciousness;
• paresis of the eye muscles;
• acute cardiovascular failure;
• intestinal paresis;
• increase in body temperature to febrile values ​​(above 38 ° C).

After experiencing delirium tremens, there is a high risk of re-development of psychosis due to continued abuse of alcoholic beverages.

Prevention

Prevention of the development of delirium tremens consists of active treatment of alcoholism, as well as carrying out extensive sanitary and educational work aimed at preventing the formation of alcohol dependence in the population.

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