Delirium Tremens
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 Tremens
LUPULINUM
Lupulin. The glandular powder separated from the strobiles of Humulus Lupulus, Linné (Nat. Ord. Cannabaceae), the common Hop. (See... / ...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... / ...thus proving useful in yeasty indigestion with acid eructations and dilation of the stomach, and in the headache due to such gastric disturbance.1
Lupulin. The glandular powder separated from the strobiles of Humulus Lupulus, Linné (Nat. Ord. Cannabaceae), the common Hop. (See... / ...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... / ...thus proving useful in yeasty indigestion with acid eructations and dilation of the stomach, and in the headache due to such gastric disturbance.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
SCUTELLARIASCCH2
The fresh green herb of Scutellaria lateriflora, Linné (Nat. Ord. Labiatae). Common in damp situations throughout the United States. Dose, 5 to... / ...owever, must not be expected from it in the latter condition; nor can it be expected to aid much in delirium tremens, and not at all in epilepsy and paralysis agitans, in both of which it has been inj... / ...a great reputation as a cure for hydrophobia, based upon the reports of New Jersey physicians, a claim which time has totally failed to sustain.1
The fresh green herb of Scutellaria lateriflora, Linné (Nat. Ord. Labiatae). Common in damp situations throughout the United States. Dose, 5 to... / ...owever, must not be expected from it in the latter condition; nor can it be expected to aid much in delirium tremens, and not at all in epilepsy and paralysis agitans, in both of which it has been inj... / ...a great reputation as a cure for hydrophobia, based upon the reports of New Jersey physicians, a claim which time has totally failed to sustain.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 Tremens
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
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 Tremens
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.