Delirium
What is delirium?
Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.
There are three types of delirium:
- Hypoactive, when you are not active and seem sleepy, tired, or depressed
- Hyperactive, when you are restless or agitated
- Mixed, when you change back and forth between being hypoactive and hyperactive
There are many different problems that can cause delirium. Some of the more common causes include:
- Advanced cancer.
- Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol use disorder (AUD).
- Dehydration and electrolyte imbalances.
- Dementia.
- Hospitalization, especially in intensive care.
- Infections, such as urinary tract infections, pneumonia, and the flu.
- Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be from withdrawal after stopping a medicine.
- Metabolic disorders.
- Organ failure, such as kidney or liver failure.
- Poisoning.
- Serious illnesses.
- Severe pain.
- Sleep deprivation.
- Surgeries, including reactions to anesthesia.
Certain factors put you at risk for delirium, including:
- Being in a hospital or nursing home
- Having dementia
- Having a serious illness or more than one illness
- Having an infection
- Older age
- Having surgery
- Taking medicines that affect the mind or behavior
- Taking high doses of pain medicines, such as opioids
The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:
- Changes in alertness (usually more alert in the morning, less at night)
- Changing levels of consciousness
- Confusion
- Disorganized thinking, talking in a way that doesn't make sense
- Disrupted sleep patterns, sleepiness
- Emotional changes: anger, agitation, depression, irritability, overexcitement
- Hallucinations and delusions
- Memory problems, especially with short-term memory
- Trouble concentrating
Your health care provider may use many tools to make a diagnosis:
- A medical history, which includes asking about your symptoms
- Physical and neurological exams
- Mental status testing, which checks for problems with your thinking and alertness
- Lab and diagnostic imaging tests
Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:
- Delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
- Dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don't change often, like they can with delirium. Dementia almost never gets better.
Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:
- Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
- Medicines, including those that control aggression or agitation and pain relievers if there is pain
- If needed, making sure that the person has a hearing aid, glasses, or other devices for communication
Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).
WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.
Felter's Materia Medica on Delirium
ADONIS VERNALIS
The whole plant of Adonis vernalis, Linné. (Nat. Ord. Ranunculaceae). Southern Europe, Siberia, and Labrador. Dose, 1/2 to 3 grains. Common Name:... / ...action resulting from chronic nephritis. Wilcox used it in chronic albuminuria, with pale urine and delirium with good results and in uremic convulsions, which had been frequent, without a return of t... / ...irritation or inflammation. 1
The whole plant of Adonis vernalis, Linné. (Nat. Ord. Ranunculaceae). Southern Europe, Siberia, and Labrador. Dose, 1/2 to 3 grains. Common Name:... / ...action resulting from chronic nephritis. Wilcox used it in chronic albuminuria, with pale urine and delirium with good results and in uremic convulsions, which had been frequent, without a return of t... / ...irritation or inflammation. 1
ARISÆMA TRIPHYLLUM
The fresh corm of Arisaema triphyllum, Torre (Nat. Ord. Araceae). Common in damp woods and wet situations in North and South merica. Common Names:... / ...iety of disorders, chiefly of the respiratory tract, and as a stimulant in low forms of fever, when delirium is marked and the membranes are inflamed and the tongue red, painful and swollen. It is sel... / ...may be given in drop doses every half to one hour, and a throat wash of one drachm of the tincture to a half glass of water may be used freely. 1
The fresh corm of Arisaema triphyllum, Torre (Nat. Ord. Araceae). Common in damp woods and wet situations in North and South merica. Common Names:... / ...iety of disorders, chiefly of the respiratory tract, and as a stimulant in low forms of fever, when delirium is marked and the membranes are inflamed and the tongue red, painful and swollen. It is sel... / ...may be given in drop doses every half to one hour, and a throat wash of one drachm of the tincture to a half glass of water may be used freely. 1
ARNICA MONTANA
The dried flower-heads of Arnica montana, Linné (Nat. Ord. Compositae). A perennial of Siberia and the cooler parts of Europe; also found in... / ...onia with typhoid conditions marked asthenia, feeble circulation, great depression, low muttering delirium, picking at the bed clothes, and dry tongue loaded with foul mucus and sordes, it is a most...1
The dried flower-heads of Arnica montana, Linné (Nat. Ord. Compositae). A perennial of Siberia and the cooler parts of Europe; also found in... / ...onia with typhoid conditions marked asthenia, feeble circulation, great depression, low muttering delirium, picking at the bed clothes, and dry tongue loaded with foul mucus and sordes, it is a most...1
BELLADONNA (Atropa belladonna)ATROP
...cations are: Pallid countenance, with frequent urination; nervous excitation, with wild and furious delirium. Large doses: mydriatic. Action.The action of Belladonna depends largely upon its chief a......t irritability and impressionability of all the senses; in some cases the hyperaesthesia amounts to delirium and it is then claimed to be most efficient to control both mild and furious outbreaks of d...1
...cations are: Pallid countenance, with frequent urination; nervous excitation, with wild and furious delirium. Large doses: mydriatic. Action.The action of Belladonna depends largely upon its chief a......t irritability and impressionability of all the senses; in some cases the hyperaesthesia amounts to delirium and it is then claimed to be most efficient to control both mild and furious outbreaks of d...1
BRYONIA
The root of Bryonia dioica, Jacquin, and Bryonia alba, Linné (Nat. Ord. Cucurbitaceae.) Europe. Common Names: Bryony, Bastard Turnip, Devil's... / ...re scant and vitiated, the nervous system markedly depressed, and the tendency is toward sepsis and delirium. The victim cares little whether he recovers or dies. There is a dry tongue, sordes, a deep... / ...its origin in irritation or erethism. Tensive or sharp pains are almost always present, and the secretion, if there is any, is small in quantit1
The root of Bryonia dioica, Jacquin, and Bryonia alba, Linné (Nat. Ord. Cucurbitaceae.) Europe. Common Names: Bryony, Bastard Turnip, Devil's... / ...re scant and vitiated, the nervous system markedly depressed, and the tendency is toward sepsis and delirium. The victim cares little whether he recovers or dies. There is a dry tongue, sordes, a deep... / ...its origin in irritation or erethism. Tensive or sharp pains are almost always present, and the secretion, if there is any, is small in quantit1
CACTUS (Selenicereus spp.)
The fresh, green stems and the flowers of Selenicereus grandiflorus (L.) Britt. & Rose (and other Selenicereus speciesMM) (Cereus grandiflorus,... / ...stric, irritation, and also affects the brain, causing confusion of mind, hallucination, and slight delirium. In excessive doses, a quickened pulse, constrictive headache, or constrictive sensation in... / ...organ were held with a strong band, it is often the most prompt of all cardiac remedies. It is a good remedy in the heart troubles produced by to1
The fresh, green stems and the flowers of Selenicereus grandiflorus (L.) Britt. & Rose (and other Selenicereus speciesMM) (Cereus grandiflorus,... / ...stric, irritation, and also affects the brain, causing confusion of mind, hallucination, and slight delirium. In excessive doses, a quickened pulse, constrictive headache, or constrictive sensation in... / ...organ were held with a strong band, it is often the most prompt of all cardiac remedies. It is a good remedy in the heart troubles produced by to1
CAFFEA
The seeds of Caffea arabica, Linné (Nat. Ord. Rubiaceae). Native of Arabia-Felix and Ethiopia; and extensively cultivated in Asia and America... / ...ng draught in acute alcoholism. and small and repeated amounts will sometimes ward off an attack of delirium tremens. Coffee is a gratefully refreshing agent for headache due to cerebral hyperaemia or... / ...preferably without sugar or cream; for use in narcotic poisoning very strong, black coffee may be given freely, both by mouth and per rectum.1
The seeds of Caffea arabica, Linné (Nat. Ord. Rubiaceae). Native of Arabia-Felix and Ethiopia; and extensively cultivated in Asia and America... / ...ng draught in acute alcoholism. and small and repeated amounts will sometimes ward off an attack of delirium tremens. Coffee is a gratefully refreshing agent for headache due to cerebral hyperaemia or... / ...preferably without sugar or cream; for use in narcotic poisoning very strong, black coffee may be given freely, both by mouth and per rectum.1
CAMPHORA
A stearopten (having the nature of a ketone) derived from Cinnamomum Camphora. (Linné), Nees et Ebermeier (Nat. Ord. Lauraceae). China and... / ...symptoms: esophageal and gastric pain, vomiting, headache, dizziness, mental confusion, drowsiness, delirium, and stupor; feeble, running, or intermittent pulse, cold skin, cold sweat, and muscular we... / ...due to gaseous distention of the stomach, or to nervous irritability. In occipital headache, from mental strain, or overstudy, small doses of 1
A stearopten (having the nature of a ketone) derived from Cinnamomum Camphora. (Linné), Nees et Ebermeier (Nat. Ord. Lauraceae). China and... / ...symptoms: esophageal and gastric pain, vomiting, headache, dizziness, mental confusion, drowsiness, delirium, and stupor; feeble, running, or intermittent pulse, cold skin, cold sweat, and muscular we... / ...due to gaseous distention of the stomach, or to nervous irritability. In occipital headache, from mental strain, or overstudy, small doses of 1
CANNABIS
...rn potentates are said to have dosed their fanatic followers with it. It produces an agreeable semi-delirium taking on the character of a sense of well-being and exhilaration-a state highly coveted by......ed too rapidly or in too large doses, exhilaration of spirits, inebriation with phantasms, illusory delirium, and sometimes strong aphrodisia precede sleep. A peculiarity in many individuals taking ca...1
...rn potentates are said to have dosed their fanatic followers with it. It produces an agreeable semi-delirium taking on the character of a sense of well-being and exhilaration-a state highly coveted by......ed too rapidly or in too large doses, exhilaration of spirits, inebriation with phantasms, illusory delirium, and sometimes strong aphrodisia precede sleep. A peculiarity in many individuals taking ca...1
CAPSICUM
The ripe fruit, dried, of Capsicum frutescens, Linné (Nat. Ord. Solanaceae). Tropical America; also cultivated in most tropical countries. Dose,... / ...h, and mouth and salivary secretions suppressed or scanty; atonic dyspepsia of drunkards; alcoholic delirium of the depressive type; congestive chill; colic, with abdominal distention; debility with f...1
The ripe fruit, dried, of Capsicum frutescens, Linné (Nat. Ord. Solanaceae). Tropical America; also cultivated in most tropical countries. Dose,... / ...h, and mouth and salivary secretions suppressed or scanty; atonic dyspepsia of drunkards; alcoholic delirium of the depressive type; congestive chill; colic, with abdominal distention; debility with f...1
CYPRIPEDIUMCYAL10
The rhizome and rootlets of Cypripedium pubescens, Swartz; and of Cypripedium parviflorum, Salisbury. (Nat. Ord. Orchidaceae.) Rich woods of the... / ...ripedium. Dose, 5 to 60 drops. Specific Indications.Insomnia, nervous irritability, neuralgia and delirium, all from atony; restlessness and muscular twitching, typhomania and tremors in low forms o... / ...Simple Syrup, enough to make 3 fluidounces. Mix. Sig.: Dose, 5 to 20 drops. If nausea occurs lessen the amount of, or omit the lobelia.1
The rhizome and rootlets of Cypripedium pubescens, Swartz; and of Cypripedium parviflorum, Salisbury. (Nat. Ord. Orchidaceae.) Rich woods of the... / ...ripedium. Dose, 5 to 60 drops. Specific Indications.Insomnia, nervous irritability, neuralgia and delirium, all from atony; restlessness and muscular twitching, typhomania and tremors in low forms o... / ...Simple Syrup, enough to make 3 fluidounces. Mix. Sig.: Dose, 5 to 20 drops. If nausea occurs lessen the amount of, or omit the lobelia.1
GAULTHERIA
The leaves of Gaultheria procumbens, Linné (Nat. Ord. Ericaceae). Damp woods and sandy soils of eastern third of the United States. Common... / ...ma. The symptoms of toxic doses are drowsiness, cerebral congestion with throbbing of the carotids, delirium, contracted or dilated pupils, visual disturbances, tinnitus aurium, paresis, somnolence, a... / ...of infants. Gaultheria is an agent of special value as a flavoring agent and preservative for water-dispensed medicines in the summer season. Fo1
The leaves of Gaultheria procumbens, Linné (Nat. Ord. Ericaceae). Damp woods and sandy soils of eastern third of the United States. Common... / ...ma. The symptoms of toxic doses are drowsiness, cerebral congestion with throbbing of the carotids, delirium, contracted or dilated pupils, visual disturbances, tinnitus aurium, paresis, somnolence, a... / ...of infants. Gaultheria is an agent of special value as a flavoring agent and preservative for water-dispensed medicines in the summer season. Fo1
HYOSCYAMUS
...estlessness in sleep; night terrors; loquaciousness; garrulousness; destructiveness; busy muttering delirium, or singing, talkativeness, amusing hallucinations and illusions, particularly in fevers; c......tation of the pupils, quickening of the respiratory and heart action, illusions, hallucinations and delirium. While the alkaloids of these drugs also act in the same general manner, there are shades o...1
...estlessness in sleep; night terrors; loquaciousness; garrulousness; destructiveness; busy muttering delirium, or singing, talkativeness, amusing hallucinations and illusions, particularly in fevers; c......tation of the pupils, quickening of the respiratory and heart action, illusions, hallucinations and delirium. While the alkaloids of these drugs also act in the same general manner, there are shades o...1
LUPULINUM
...5 to 30 drops. Specific Indications.Nervousness, irritability, disposition to brood over trouble, delirium, insomnia, cerebral hyperemia; genital and mental irritability associated with spermatorrhe......elieves irritation of the bladder, with frequent urination, and is quite efficient in chordee. When delirium tremens is accompanied by cerebral hyperemia it is of considerable service. Insomnia due to...1
...5 to 30 drops. Specific Indications.Nervousness, irritability, disposition to brood over trouble, delirium, insomnia, cerebral hyperemia; genital and mental irritability associated with spermatorrhe......elieves irritation of the bladder, with frequent urination, and is quite efficient in chordee. When delirium tremens is accompanied by cerebral hyperemia it is of considerable service. Insomnia due to...1
MACROTYS (Cimicifuga racemosa)CIRAC
The rhizome and rootlets of Cimicifuga racemosa (Linné), Nuttall (Nat. Ord. Ranunculaceae). A conspicuously handsome perennial widely found in... / ...character, and a reduction in the rate and force of the circulation. A condition closely resembling delirium tremens is said to have been produced by it. Full doses cause a severe frontal headache, wi...1
The rhizome and rootlets of Cimicifuga racemosa (Linné), Nuttall (Nat. Ord. Ranunculaceae). A conspicuously handsome perennial widely found in... / ...character, and a reduction in the rate and force of the circulation. A condition closely resembling delirium tremens is said to have been produced by it. Full doses cause a severe frontal headache, wi...1
WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.
Physician's Materia Medica on Delirium
ACETANILID (Phenylacetamide; Antifebrin.)
Analgesic, antipyretic, antiseptic; a powerful depressant to the spinal nerve centers. Used especially in neuralgic and rheumatic affections to control pain. in migraine, in febrile conditions accom panied with pain. in delirium tremens, in insomnia and as a remedy for obstinate vomiting. Externally it is useful as a surgical dress ing, resembling iodoform in its action. Incompatible with bromides and iodides and with spirit of nitrous ether. It is advantageously combined with Caffeine which dim2
Analgesic, antipyretic, antiseptic; a powerful depressant to the spinal nerve centers. Used especially in neuralgic and rheumatic affections to control pain. in migraine, in febrile conditions accom panied with pain. in delirium tremens, in insomnia and as a remedy for obstinate vomiting. Externally it is useful as a surgical dress ing, resembling iodoform in its action. Incompatible with bromides and iodides and with spirit of nitrous ether. It is advantageously combined with Caffeine which dim2
APOMORPHINE
Derivative alkaloid from MORPHINE. Expectorant or emetic ac cording to the dose. Small doses act as a sedative in delirium tre mens.' As an expectorant 0.001 to 0.0025 Grm. (1-60 to 1-25 gr.) may be given; as an emetic 0.06 (1-10 gr.) usually suflices (always given for this purpose hypodermatically).2
Derivative alkaloid from MORPHINE. Expectorant or emetic ac cording to the dose. Small doses act as a sedative in delirium tre mens.' As an expectorant 0.001 to 0.0025 Grm. (1-60 to 1-25 gr.) may be given; as an emetic 0.06 (1-10 gr.) usually suflices (always given for this purpose hypodermatically).2
CAPSICUM
The fruit of CAPSICU M FASTIGIATU M, Blume. Internally a powerful stimulant and revulsive; externally rubefacient and counter-irritant. Prescribed in delirium tremens, in dyspepsia, in bowel complaints and frequently in combination with cathartics as a car minative. Dose, 0.06 to 1.0 Grm. (1 to 15 grs.) or more.2
The fruit of CAPSICU M FASTIGIATU M, Blume. Internally a powerful stimulant and revulsive; externally rubefacient and counter-irritant. Prescribed in delirium tremens, in dyspepsia, in bowel complaints and frequently in combination with cathartics as a car minative. Dose, 0.06 to 1.0 Grm. (1 to 15 grs.) or more.2
SKU LLCAP (Scutellaria)
The flowering herb of SCUTELLARIA LATERIFLORA, Lin. Tonic, nervine, antispasmodic. Prescribed for relief of nervous excitability and restlessness, in chorea, in functional cardiac disorders and for procuring sleep in delirium tremens.2
The flowering herb of SCUTELLARIA LATERIFLORA, Lin. Tonic, nervine, antispasmodic. Prescribed for relief of nervous excitability and restlessness, in chorea, in functional cardiac disorders and for procuring sleep in delirium tremens.2
VALERlAN
The rhizome and roots of VALERIANA OFFICINALIS Lin. Antispasmodic, nervine. Much used to quiet nervous restlessness and insomnia, especially in typhoid conditions, in hysteria and, generally combined with morphine, in delirium tremens; to relieve nervous headaches, for infantile colic, etc. See also Acid Valerianic.2
The rhizome and roots of VALERIANA OFFICINALIS Lin. Antispasmodic, nervine. Much used to quiet nervous restlessness and insomnia, especially in typhoid conditions, in hysteria and, generally combined with morphine, in delirium tremens; to relieve nervous headaches, for infantile colic, etc. See also Acid Valerianic.2
WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.
Physician's Therapeutics Memoranda on Delirium
DELIRIUM TREMENS
Hypnotic remedies are indicated, particularly bromides with chloral, Bromanodyne, hyoscine, sulphonal; also nervines, especially ammonium and morphine valerianates, monobromated |camphor; capsicum as a gastric stimulant.2
Hypnotic remedies are indicated, particularly bromides with chloral, Bromanodyne, hyoscine, sulphonal; also nervines, especially ammonium and morphine valerianates, monobromated |camphor; capsicum as a gastric stimulant.2
References
1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.