What are treatments for delirium tremens (DTs)?

Updated: Nov 06, 2020
  • Author: Michael James Burns, MD, FACEP, FACP, FIDSA; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Treatments for delirium tremens

See the list below:

  • Supportive therapy: This important component of treatment of alcohol withdrawal syndrome and delirium tremens (DTs) includes providing a calm, quiet, well-lit environment; reassurance; ongoing reassessment; attention to fluid and electrolyte deficits; and treatment of any coexisting addictions.

  • Thiamine: Thiamine can be useful for preventing Wernicke encephalopathy (confusion, ataxia, ophthalmoplegia), an acute disorder caused by thiamine deficiency, and Korsakoff syndrome (memory impairment, amnesia), a late manifestation of thiamine deficiency.

  • Magnesium: Alcoholic individuals frequently have large total body deficits of magnesium, and symptoms and signs of magnesium deficiency include hyperactive reflexes, weakness, tremor, refractory hypokalemia, reversible hypoparathyroidism with hypocalcemia, and cardiac dysrhythmias.

  • Benzodiazepines: Based on the Riker Sedation Agitation Scale (RSAS) or the Richmond Agitation Sedation Scale (RASS), very-high-dose bolus therapy, with addition of phenobarbital as needed, may help reduce the need for mechanical ventilation and the length of time in the ICU.

  • Intravenous ethanol infusions: These are not recommended for prophylaxis or treatment of alcohol withdrawal.

See Treatment.


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