This clinical disorder is a DELIRIUM that occurs after abrupt cessation of, or reduction in, ALCOHOL consumption in an individual who has been a heavy drinker for many years. It represents the most severe form of the alcohol WITHDRAWAL state and is not very common. It is associated, however, with a significant mortality rate of those who develop it (10-15%), if left untreated.

Typically, the delirium sets in forty-eight to seventy-two hours after the last drink or after reduction in drinking. The course of illness is generally short, lasting, in most cases, two to three days. The disorder becomes significantly more life threatening if there is concurrent physical illness, such as liver failure, infection, or trauma.

Clinical signs and symptoms are the same ones that are characteristic of a delirium and include disorientation, fluctuating levels of consciousness, vivid hallucinations, delusions, agitation, fever, elevated blood pressure, rapid pulse, sweating, and tremor. The delirium may at times be preceded by a withdrawal seizure. Close monitoring and medical treatment in a hospital setting are required.

See Also

Bibliography

GOODWIN, D. W. (1989). Alcoholism. In H. I. Kaplan &B. J. Sadock (Eds.), Comprehensive textbook of psychiatry, 5th ed., vol. 1. Baltimore: Williams & Wilkins.

PLUM, F., & POSNER, J. B. (1980). The diagnosis of stupor and coma, 3rd ed. Philadelphia: Davis.