One of the most serious complications of alcohol withdrawal may take days to show up.

If you or a loved one struggle with alcohol abuse, you might worry about alcohol withdrawal. Withdrawal from alcohol is an uncomfortable process and can be dangerous or even deadly. One of the dangerous complications of alcohol withdrawal is a condition known as delirium tremens, or DT, which can be life-threatening.

Article at a Glance:

Delirium tremens, or DT, is a serious form of alcohol withdrawal syndrome.

If left untreated, the chance of death from DT is 37%. Even if treated, the chance of death from DT is up to 15%.

A hospital stay is usually required for DT because it can be serious.

Seek medical attention immediately if there are signs of DT.

Symptoms of DT can occur anywhere from 48 hours to 10 days after the last drink.

What Is Delirium Tremens?

If you drink alcohol heavily for a long time and then suddenly stop, you are at risk of a condition known as alcohol withdrawal syndrome, or AWS. This syndrome can cause a variety of symptoms. Some AWS symptoms are barely noticeable, but some are severe. Furthermore, some AWS symptoms will show up within a few hours, and some may take days to show up. The most severe form of AWS is DT, which combines serious psychological and nervous system changes. About five percent of people with AWS develop DT.

What Causes Delirium Tremens?

Drinking large amounts of alcohol over a long time harms your brain. In particular, alcohol interferes with your body’s ability to regulate brain chemicals including gamma-Aminobutyric acid (GABA) and glutamate. These chemicals have opposite effects in the brain: glutamate excites the cells in the brain while GABA calms them.

The effect of GABA in the brain is enhanced to match the quantity of alcohol consumed over time. Because brain activity becomes depressed with chronic drinking, the brain becomes highly sensitive to any glutamate produced. When you suddenly stop drinking alcohol, the brain can easily become over-excited because it is overly sensitive to glutamate, and there is not enough GABA to calm the brain. This over-excitement can lead to the unpleasant effects of AWS, including DT.

Some people who struggle with alcohol abuse are more at risk for DT than other people. Risk factors include:

  • Chronic alcohol use
  • History of DT
  • Seizure history
  • Being sick, or having certain other medical conditions like heart or liver disease
  • Prior (unsuccessful) attempts at an alcohol detox

Symptoms of Delirium Tremens

Symptoms of DT may start to show up as early as 48 hours after the last drink and generally occur within the first 72 hours. However, in some cases, DT symptoms may take as long as 10 days to show up. Research suggests that if you have had DT before, then you may be more likely to get symptoms of DT earlier during withdrawal. Also, you may get other symptoms of AWS such as nausea and vomiting earlier during withdrawal and later may progress to a more serious form of withdrawal like DT.

Symptoms of DT include:

  • Hallucinations
  • Confusion
  • Agitation
  • Fast heartbeat
  • High blood pressure
  • Fever
  • Sweating

If you suspect that you or a loved one has DT, it is critical to seek medical attention right away. Waiting can be deadly.

How Long Does Delirium Tremens Last?

Typically, DT will last anywhere from five to seven days. The amount of time is usually based on how long you’ve been drinking before seeking treatment and how much alcohol you drank before getting help.

Remember, the sooner you get help for alcohol use disorder or addiction, the lower your chances are of experiencing life-threatening effects of alcohol withdrawal. If you are experiencing symptoms of DT, get help immediately.

Treating Delirium Tremens

Timely treatment for DT is highly important. Without proper treatment, the death rate from DT is 37 percent. If you have DT, you may be hospitalized so that you can be monitored and treated. Likewise, if you have a history of DT, you are at higher risk for getting it again, so you are likely to be hospitalized even if your alcohol withdrawal symptoms do not seem too severe to you.

Usually, conventional treatment for DT involves keeping you sedated using a drug from the benzodiazepine class, which calms the brain down. This treatment stops the brain from being over-excited, and thus reduces the symptoms of DT. If you have DT, you may also be dehydrated and need IV fluids. You might also need mood-regulating medications, to calm any agitation and hallucinations.

Unfortunately, even with the proper care, DT is fatal in up to 15 percent of people.

If you suspect that you or a loved one is at high risk for AWS and DT, contact The Recovery Village today. Our trained professionals at The Recovery Village are here to help you stop alcohol safely. The call is free and confidential, and you don’t have to commit to a program to learn more about treatment.

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Editor – Camille Renzoni
Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

Abdul Rahman; Manju Paul. “Delirium Tremens (DT).” StatPearls, updated November 18, 2018. Accessed April 14, 2019.

Department of Veterans Affairs. “VA/DoD Clinical Practice Guideline for t[…]lization Pocket Card.” (n.d.) Accessed April 14, 2019.

Antonio Mirijello, et al. “Identification and Management of Alcohol Withdrawal Syndrome.” U.S. National Library of Medicine, published in March 2015. Accessed April 14, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.