Talk:Delirium tremens

This simply isn't true
"Withdrawal from other drugs which are not sedative-hypnotics, such as opioids, marijuana, cocaine etc. do not have major medical complications and withdrawal is therefore not life threatening" Withdrawal from opioids absolutely has MAJOR medical complications! I'd imagine one would have to have been living under a rock for about fifty years to not know that. 24.67.72.62 (talk) 05:24, 27 February 2011 (UTC)

I'm not sure if it's appropriate for me to mention in this section, but reference 3 says "Alcohol is one of the more dangerous substances from which to experience withdrawal." (emphasis added); As opposed to "most" dangerous, also erroneously stated stated, this one in the lede of the article Relishcolouredhat (talk) 01:47, 13 December 2016 (UTC)
 * One of the more and one of the most is the same thing. We are also required to paraphrase. Doc James  (talk · contribs · email) 01:42, 14 December 2016 (UTC)

Removed Factual Inconsistency
"Although used rarely, an alcohol drip may be prescribed to sedate severe patients, who will then need to be "weaned" off of the alcohol."

This is factually incorrect. Alcohol is never administered by physicians to avert withdrawal symptoms except in cases of medical misconduct.

There is also no medical protocol for someone to be, "weaned off of the alcohol".

While it is true that some alcoholics in withdrawal are given ethanol this is only within the scope of co-morbidity. If the remark is to be reinstated, then a reference should be provided alongside which demonstrates medical practice advocating that alcohol be given for the purpose of averting withdrawal, and not some other issue. —Preceding unsigned comment added by 71.208.122.170 (talk) 14:31, 10 November 2010 (UTC)

possible error
i think theres an error with this in the article. "Unlike the withdrawal syndrome associated with opiate dependence, delirium tremens (and alcohol withdrawal in general) can be fatal." opiate withdrawal can in fact be fatal. i know a few people who work at rehab facilities. opiate and alcohol addicts, if severe enough, constantly have their hearts monitored because there have been cases of heart failure due to withdrawal. i think its more common in older or unhealthy people. —Preceding unsigned comment added by 68.188.195.13 (talk) 20:05, 28 July 2008 (UTC)

Certainly. Jerry Garcia died at Betty Ford Clinic while withdrawing fom Heroin.68.231.184.217 (talk) 16:02, 19 June 2011 (UTC)

heres a source. http://www.experiencefestival.com/a/Heroin_-_Withdrawal/id/1323298 i'm sure their are many others from google if this one isnt good enough —Preceding unsigned comment added by 68.188.195.13 (talk) 20:11, 28 July 2008 (UTC)

The majority of heroin addicts also misuse and are often physically dependent on other "downers" as part of their poly drug using behaviour including alcohol, benzodiazepines and sometimes barbiturates. Cardiovascular problems can occur from during alcohol withdrawal and benzodiazepine or barbiturate withdrawal. Withdrawal from CNS GABAergic depressants such as alcohol, benzodiazepines and barbiturates are well known for having fatal complications during withdrawal (most notably seizures). Pure opiate withdrawal is not regarded as being a life threatening withdrawal syndrome. The common cold or even sex can kill the elderly or severely debilitated.-- Literature geek |  T@1k?  22:36, 28 July 2008 (UTC)

drawings
"drawings on wallpaper that the patient would perceive as giant spiders ready to attack her or him)"

That is an illusion, not a hallucination!

An illusion is defined ad a "deformed perception of reality", that is, perceiving something while the real object is something completely different; a hallucination is a "perception without object", that is, perceiving something while there is nothing that could generate that perception.

So, mistaking wallpaper drawings for spiders is an illusion; seeing spiders on the walls of a room where there are no spiders and nothing that could be mistaken for a spider (no drawings on the wallpaper) is a hallucination. Devil Master 13:45, 15 Apr 2005 (CET)

So, a person experiencing these symptoms is illusionating rather than hallucinating? I'm sorry, but this seems like meaningless semantics to me. I think, at least as far as popular usage is concerned, any person seeing things that do not exist, due to a medical condition or intoxication which warps the perception, can be said to be experiencing a hallucination. Of course, when you are able to see the sailboat in the Magic Eye picture, this is an illusion, but when the wallpaper becomes alive and begins attacking you, I think this can be properly characterized as a hallucination regardless of whether the vision is precipitated by some existing object or not.67.46.0.13 06:53, 4 September 2006 (UTC)

It is not a matter of semantics but is important diagnostically. Illusion-related psychoses have a different psychiatric differential than hallucination-related ones especially when considering drug intoxication. If you want to use the terms in a non-specific manner then you should be writing for the simple English domain of wikipedia.

Police contents???
Schitzos have hallucinations with police contents??? Im not a psychiatrist but even I think this is wrong??--Light current 21:39, 23 September 2005 (UTC)

Fact missing in intro: WHAT IS DT???
The article's introduction is only talking about the causes of delirium tremens, but it doesn't say what it actually is!! What kind of condition is it? If I asked you "what is delirium tremens?", would the right answer be "It's associated with alcohol, and it's fatal!"? As most other Wikipedia articles of this type would 'agree', that's not correct. Kreachure 16:22, 21 December 2005 (UTC)

Confusing
"Despite notions to the contrary, because of delirium tremens, alcohol withdrawal is the most dangerous because it has the possibility of being fatal." What does this mean? What notions? When it says "most dangerous", does it mean among kinds of withdrawal or does it mean that it's DT that makes alcohol withdrawal dangerous? NickelShoe 06:43, 23 December 2005 (UTC)
 * Thank you, anonymous user, for clearing that up. NickelShoe 19:24, 28 December 2005 (UTC)

Disambiguation?
the article List of commercial brands of beer links here instead of an article on the beer of the same (or similar) name.
 * The correct article exists at Delirium Tremens (beer). I'm going to take the liberty of linking to that article at the top of this one. NickelShoe 20:34, 6 February 2006 (UTC)

Spambot ruined article!!!
Seems like a spambot ruined this article. Can someone put it back?

Number One on Google
ranks #1 on Google for "Delium tremens"NumberOneGoogle 18:57, 25 November 2006 (UTC)

It would be nice if someone re-wrote or added a subsection to "Causes", the current text is too technical for a general audience.

Edited Causes
I added a few lines to the causes, hope it helps

Cultural references section
I think this section contains a lot of material that may be peripheral to the main topic. It's just a very long list of fictional references, and highbrow as many of them might be, it's not explained why depictions of delerium tremens might have a special cultural significance. Alcohol use and addiction certainly are important themes in fiction, but I'm not convinced that delerium tremens itself is significant in the same way, except as an illustration of those themes. For an example of addressing the significance of fictional alcoholism, see Alcoholism. Notice it mentions a few specific examples instead of just listing off a whole ton of stuff. I also think it might be good to have an article on Alcohol use in fiction or the Cultural impact of alcohol use for this type of material.--Eloil 11:01, 30 April 2007 (UTC)

Hello. My name is Scott Seguin. This may not seem important. But the "cultural reference" to The Brothers Karamazov is simply not true. I read the book last year. And Ivan Karamazov is not an alcoholic in this novel. As a matter of fact, he is not even portrayed in the novel as drinking at all. It is claimed that Ivan hallucinates the devil in the midst of a delirium tremens, when in fact Dostoyevsky makes it clear that he is going insane due to a deep emotional conflict. This irritates me. If someone wants to write an article and claim knowledge of all these disparate facts, in my opinion you better damn well know them as facts, and not just put them up there and think to oneself, "well that sounds good." So, in short, if I can gain access to this article, I am going to delete the misformation. If it is no longer there, my work is done. --Scott Seguin, the information Nazi.

Just before his confrontation with the Devil, Ivan is described as being on the verge of белая горячка- literally "white fever". This is usually translated as delirium tremens, but it can also be used to refer to any state of fevered hallucination. Given that this article deals with DT as it relates to substance withdrawal and not as a general state of hallucination, the white fever suffered by Ivan does not fit in this article as it is brought on by emotional and spiritual conflict. Therefore I have removed the reference. Edwarddecker 22:23, 20 August 2007 (UTC)

I am the one who orginally added the Brothers Karamazov reference -- in the translation I read (by David McDuff), Ivan was described as specifically suffering from delirium tremens. A footnote by the author (McDuff, not Dostoyevsky) reads "In Dostoyevsky's Russian text, Ivan's illness is defined as belaya goryachka or delirium tremens (DTs). There seems little doubt that Dostoyevsky wishes to stress Ivan's family nature - Ivan is a Karamazov, too, with the Karamazov vices.  Although we see little or nothing of Ivan's drinking, hints of it are scattered throughout the novel (...in particular, for example, ...Ivan's constant references to 'dashing the cup to the floor').  Dostoyevsky never managed to write the 'explanation' of Ivan's illness that was to form the subject of an article in A Writer's Diary, but from his letters it is clear that he consulted several doctors on the subject of delirium tremens, the symptoms of which Ivan unquestionably displays." I do, however, understand the reasons for deletion, but I think it ought to be known that it wasn't just my own personal opinion that prompted me to make the edit in the first place. --Tim B.

I added it again for the same reason that Tim B. did. Then I discovered that I wasn't the first. I'll leave it there since I'm not sure Scott Seguin's credentials ("I read the book last year") are greater than David McDuff's. I guess it boils down to the translation from Russian. Maybe a Russian should comment. Regarding Eloil's comment, it might make sense to do away with the cultural references altogether. Such references will probably be included in their "home" articles anyway and will be easily searchable. -- Kirk D. —Preceding unsigned comment added by 84.212.141.200 (talk) 01:25, 25 November 2007 (UTC)

Dissapointed, re: Benzodiazepine (or in rare cases barbiturate) withdrawal
This article is written as if it's exclusively for alcohol withdrawal. Benzodiazepine withdrawal causes DTs and sympotoms just as bad if not worse depending on the dosage and duration of use. Instead of one small note regarding benzos/barbiturates (causing withdrawal), this article should encompass both scenarios. Benzodiazepine is a far larger problem than acknowledged, it's just one that is treated with...more benzodiazepines! As such, it is a grossly underreported problem (well, it isn't a problem at face value if you have a consistent supply.) It should also mention the use of alcohol to combat benzodiazepine withdrawal (not as a suggestion, just stating the facts of life.)

A small tidbit I feel I should share, there is some debate amongst the scientific community, and this is *TOTALLY* anecdotal, but having been on high-dose clonazepam, alprazolam was unable to fully cure the DTs. Klonopin, in my experience, is superior in combatting DTs. This would be long-term - it doesn't have a fast duration of action for emergencies. The fact that clonazepam is used as a very likely choice for seizure disorders backs this up a bit. It DOES, however, have a long duration of action, allowing for once a day dosing and a stable treatment regime, the key reason diazepam is used typically (because it's metabolites are extremely long-acting.) I will say I do think however that alprazolam is not 2mg to 20mg diazepam as commonly believed and this is getting around to the scientific and medical community finally.

Let me hear your feedback before I try any editing. I will look to see if I can back up my anecdotal notes (which of course I wouldn't add without a proper reference.)

Malnutrition and infection are "psychological"??
I am no expert on this topic, but the following sentence seems confusing or possibly inaccurate:


 * "It is possible that psychological (i.e., non-physical) factors also play a role, especially those of infections, malnutrition, or other underlying medical disorders - often related to alcoholism."

Malnutrition and infection are not psychological disorders. Did you mean that psychological factors lead to malnutrition and infection? And if so, that these (malnutrition and infection) exacerbate DT?

GreenRegsAndHam (talk) 23:37, 14 January 2008 (UTC)GreenRegsAndHam

I agree that this needs clarification. Maybe the author meant psychological conditions arising from infection, malnutrition, or other underlying medical disorders. If this is not clarified, I think it should be removed, as it is extremely confusing.

Mahasanti (talk) 15:38, 1 April 2008 (UTC)

Error
"High doses may be necessary to prevent mortality."

Are you sure you don't mean "to prevent death"? Mortality is even less preventable. —Preceding unsigned comment added by 128.120.100.220 (talk) 23:23, 3 March 2009 (UTC)

Someone please proof-read
This line is brilliant! : "Confusion is often noticeable to onlookers as individuals will have trouble constructing simple sentences or making basic calculations logic."

Magnesium deficiency

 * I read somewhere that delirium tremens can be caused by magnesium deficiency. Is this true? Anthony Appleyard (talk) 22:53, 22 June 2011 (UTC)

Delirium tremens - Latin for "shaking frenzy"

 * This is obviously a bad translation. Use google translate and it comes up as trembling delirium.Muleattack (talk) 22:17, 9 December 2011 (UTC)
 * The Google translater English to Latin is not good: "the duck swallowed the frog" became "anas devoravit ranae": wrong case, should be "ranam". Anthony Appleyard (talk) 12:31, 24 June 2012 (UTC)
 * Thank God that I am teetotal. Anthony Appleyard (talk) 21:30, 16 January 2017 (UTC)

Percentage
the introduction says: "...fewer than about 50% to 60% of alcoholics..." I'm not an English native speaker nor I know how many alcoholics in the US develop DT; but fewer than about 50-60% makes no sense to me. The source says "fewer than 50%", that sounds better. — Preceding unsigned comment added by 78.152.118.233 (talk) 16:12, 27 February 2012 (UTC)

NEJM review
10.1056/NEJMra1407298 JFW &#124; T@lk  11:34, 28 November 2014 (UTC)

Unreffed trivia

 * In the 1945 film The Lost Weekend, an alcoholic writer named Don, played by Ray Milland, is admitted to a hospital's alcoholic ward. As one of the other alcoholic patients appears to go into delirium tremens, Don escapes the hospital and heads home to drink. Following his last consumption of liquor, he experiences DTs when an illusion of a small rodent crawls out of a hole in the wall. He then hallucinates a bat flying through the room as the bat proceeds to devour the small rodent.
 * In the 1962 film Days of Wine and Roses, public relations man Joe Clay (played by Jack Lemmon) is committed to a sanitorium twice. In the first instance, he is held in a straitjacket and in a padded room while experiencing delirium tremens.  In the second instance, Joe is committed after breaking into a liquor store and afterwards wakes in the sanitorium, strapped down to a table and sweating profusely, whereupon his Alcoholics Anonymous sponsor Jim Hungerford (played by Jack Klugman) informs him that "For two days there was a little green man chasing you around with pruning shears."
 * In the 2003 film The Last Samurai, Nathan Algren (Tom Cruise), a disenchanted ex-United States Army captain and an alcoholic, who is traumatized by his experience fighting in the Civil War and the Indian Wars, is treated by the Hirotaro family in the throes of delirium tremens after being captured in battle with samurai troops led by Katsumoto.
 * In the film Leaving Las Vegas, the main character, Ben Sanderson (Nicolas Cage), suffers from the DTs after a drinking binge, and rushes to his liquor supply to prevent them from continuing.
 * In the novel L'Assommoir (1876), by French author Émile Zola, the husband of the heroine Gervaise, an alcoholic roofer named Coupeau, succumbs to delirium tremens in a Parisian hospital.
 * Ethan Thomas, protagonist of the video game Condemned 2, has become an alcoholic since the events of the previous game and must regularly consume whiskey to prevent the violent shaking of his delirium tremens from spoiling his aim.
 * The protagonist of Malcolm Lowry's 1947 novel Under the Volcano suffers from delirium tremens.
 * In the M*A*S*H episode "Bottoms Up", an alcoholic nurse gets delirium tremens.
 * In the film Everything Must Go, the character Nick Halsey (played by Will Ferrell) suffers from delirium tremens in the movie.
 * In the "Birthmarks" episode of season 5 of the television series House MD, a patient who is an alcoholic suffers from delirium tremens while being treated in the hospital.
 * In the 1989 CBS Hallmark Hall of Fame television movie My Name Is Bill W., Bill Wilson (co-founder of Alcoholics Anonymous) is admitted to the hospital where one of the doctors claims Bill is going through the early stages of delirium tremens. Later in the movie, he is strapped down to a bed appearing to once again have the symptoms of DTs.
 * The fraternity letters Delta Tau Chi (ΔΤΧ) from Animal House could be a reference to delirium tremens or possibly detox.
 * Irish folk singer Christy Moore wrote a song titled Delirium Tremens, humorously describing a man going through the symptoms, which features on his 1985 album Ordinary Man.
 * In the 2013 Bollywood movie Matru Ki Bijlee Ka Mandola, the character Harry Mandola (played by Pankaj Kapur) suffers from DT, and has hallucinations of a grinning pink buffalo.
 * In the third episode of the third season of television show Perception, Dr. Daniel Pierce interviews a suspect who is suffering from DT.
 * On the 26th of December 1989 Huyghe Brewery in Melle, Belgium started the production of a brand of golden ale they call "Delirium Tremens". The beer is still produced today and has a Beer Advocate score of 92 and is distributed world wide.
 * In the 1974 TV film The Morning After, an alcoholic named Charlie Lester, Dick Van Dyke, In a desperate attempt to stop drinking, Charlie takes a vacation and goes alone to a seaside resort. He winds up passed out on the beach. He suffers a terrifying attack of delirium tremens and wakes up in a mental ward.
 * In the 2015 mini-comic adaptation of the novel Dead Endings, the main character is drawn with a graphical representation of Delirium Tremens as she interacts with her companion at a bar.

Moved here Doc James  (talk · contribs · email) 14:08, 5 June 2015 (UTC)

Why are DTs anything other than 'adrenaline syndrome'?
Why is it not self-evident that boozers "can handle their drink" - appear relatively sober notwithstanding their high consumption - because the body combats the CNS depression of alcohol with epinephrine (adrenaline) release? Why is it not self-evident excess epinephrine is why so many alcoholics can nevertheless work like demons the following day? That is, because they're 'speeding'? And MUST drink to combat the CNS stimulation? Why is it not self-evident the symptoms of DTs are the symptoms of '[excessive] adrenaline syndrome', due to the abrupt cessation of the moderating CNS depressor - alcohol? Just as 'shell-shock' or 'battle fatigue' evidence adrenaline syndrome? That is, chronic over-exposure to adrenaline? 122.151.210.84 (talk) 04:04, 14 January 2023 (UTC)


 * Because adrenaline doesn't last long enough in a person's system to affect what they do the next day. It begins to wear off in minutes, not hours.  That's why. Ask a doctor. This isn't the place for personal opinions or non-professional theories about medicine. 174.171.71.34 (talk) 09:01, 14 July 2023 (UTC)