Alcohol Dependence / Delirium Tremens Quiz
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Insomnia
Heart palpitations
Panic attack
Hallucinations
Tremors
Palpitations
Seizures
Convulsions
Shaking hands
Disoriented
Unable to sleep
Seeing things that aren't there
Not seeing your symptoms? No worries!
What is Alcohol Dependence / Delirium Tremens?
A condition in which the patient depends on alcohol and experiences withdrawal symptoms if they don't have a drink. These symptoms can range from mild (e.g., irritation, sleeplessness) to severe (confusion, coma, seizures).
Typical Symptoms of Alcohol Dependence / Delirium Tremens
- Hand tremors, irritability, palpitations and insomnia that occur when stopping alcohol
- Recent changes in mental state
- Need a drink first thing in the morning (eye-opener) to steady my nerves
- I no longer function well at work or home because of drinking
- Fine tremors of the hands or fingers
- I always end up drinking more than I planned to
- Difficulty concentrating
- Uncontrollable movements
Diagnostic Questions for Alcohol Dependence / Delirium Tremens
Your doctor may ask these questions to check for this disease:
- Do you experience hand shaking or irritation after quitting alcohol?
- Recently, are you more confused than before?
- Do you often drink alcohol in the morning to cure a hangover?
- Are you drinking more and neglecting family or job?
- Do you experience fine tremors in your hands or fingers?
Treatment of Alcohol Dependence / Delirium Tremens
Severe symptoms necessitate emergency medical care. Patients are hospitalized and given medications to manage withdrawal and prevent complications. Fluids and vitamins are administered through a needle in the vein to support the patient's wellbeing and protect the brain. In cases of seizures and severe mental confusion, the patient is cared for in the intensive care unit, typically with breathing support and seizure-stopping medications.
Reviewed By:
Saqib Baig, MD, MS (Pulmonology, Critical Care, Internal Medicine)
Dr. Baig graduated from Army Medical College (NUST) Pakistan in 2007. He did his internal medicine training from Baltimore, Maryland, USA during the years 2009-2013. He joined the internal medicine faculty practice at Medical College of Wisconsin in USA for 2 years before pursuing advanced training. He completed his pulmonary disease and critical care medicine fellowship from Rutgers Robert Wood Johnson Medical School from 2015-2018. | | During his fellowship, Dr. Baig completed his master's in health care services management through Rutgers Business School. He currently serves as the medical director of respiratory therapy and pulmonary function lab and the clinical director of the COPD program at the Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University. He holds the Assistant Professor of Medicine rank at Sidney Kimmel Medical College at Thomas Jefferson University. Dr. Baig's interests lie in respiratory physiology, airways disease, and data science.
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Hand shaking when I'm not drinking
- Confusion
- My heart pounds when I'm not drinking
- I get frustrated if I don't drink
- Change in mental status
- I can't sleep without drinking
- Alcohol withdrawal
- Appears dazed
- Doesn't know the time
- Hand twitching
- Doesn't know where he/she is
- Doesn't know who he/she is
- Losing grip in hands and dropping things
- Hands shaking after workout
- Hand muscle spasms
See full list
Symptoms Related to Alcohol Dependence / Delirium Tremens
Diseases Related to Alcohol Dependence / Delirium Tremens
FAQs
Q.
Are these the DTs? Why your brain is reacting and medical next steps.
A.
Delirium tremens are the most severe form of alcohol withdrawal, triggered when heavy drinking stops and the brain’s calming signals are low while stimulating signals are high, causing overdrive with severe confusion, hallucinations, shaking, racing heart, fever, and sometimes seizures, typically 48 to 72 hours after the last drink. This is a medical emergency, so seek urgent care for red flag symptoms and discuss supervised detox and hospital treatments like benzodiazepines, fluids, electrolytes, and thiamine; there are several factors and timing details that can change your next steps. See below for exactly what to watch for, who is at higher risk, and how to act now.
References:
* Newman R, Baram G, Abraham P. Delirium Tremens. [Updated 2024 Jan 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:
* Myrick H, Anton RF. The Neurobiology of Alcohol Withdrawal. Semin Liver Dis. 2018 Feb;38(1):22-31. doi: 10.1055/s-0037-1608931. Epub 2018 Feb 8. PMID: 29429188.
* Reus VI, Fochtmann BK, Eyler LT, American Psychiatric Association. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder. Am J Psychiatry. 2017 Nov 1;174(11):1083-1084. doi: 10.1176/appi.ajp.2017.17411083. PMID: 29092497.
* Schuckit MA. Recognition and Management of Withdrawal Delirium (Delirium Tremens). N Engl J Med. 2014 Nov 27;371(22):2109-13. doi: 10.1056/NEJMcp1407232. PMID: 25427111.
* Ntais D, Anagnostis P, Goulis DG. Risk Factors for Delirium Tremens Development: A Systematic Review and Meta-Analysis. J Clin Med. 2020 Oct 11;9(10):3241. doi: 10.3390/jcm9103241. PMID: 33050444; PMCID: PMC7601550.
Q.
Is it Alcohol Withdrawal Symptoms? Why Your Brain is Misfiring and Medically Approved Next Steps
A.
Alcohol withdrawal happens when a brain adapted to regular drinking becomes overactive after you cut back or stop, causing shakiness, anxiety, sweating, insomnia, and in severe cases seizures or delirium tremens that need emergency care. There are several factors to consider, and medically approved next steps include close monitoring in the first 24 to 72 hours, speaking to a doctor, and considering supervised detox with seizure prevention and vitamin support, so see the complete guidance below to understand warning signs and which actions are safest for you.
References:
* Mirijello A, D'Angelo C, Ferrulli A, et al. Alcohol Withdrawal Syndrome: Mechanisms, Manifestations, and Management. Alcohol Clin Exp Res. 2015 Jul;39(7):1108-18. doi: 10.1111/acer.12759. Epub 2015 Jun 13. PMID: 26070624.
* Schuckit MA. Recognition and Management of Withdrawal Delirium (Delirium Tremens). N Engl J Med. 2014 Nov 27;371(22):2109-13. doi: 10.1056/NEJMcp1407230. PMID: 25427110.
* Lingford-Hughes AR, Kalk NJ, Haber PS. Evidence-based pharmacotherapy for alcohol withdrawal and relapse prevention: A systematic review. J Psychopharmacol. 2018 Nov;32(11):1145-1159. doi: 10.1177/0269881118790333. Epub 2018 Sep 3. PMID: 30176882.
* Becker HC. Alcohol withdrawal syndrome: neurobiology and pharmacology. Curr Top Behav Neurosci. 2011;13:259-71. doi: 10.1007/7858_2011_130. PMID: 22108169.
* Mellors J, Harrison D, Smithard D. Alcohol withdrawal syndrome: diagnosis, assessment and management. Br J Hosp Med (Lond). 2015 Feb;76(2):C28-31. doi: 10.12968/hmed.2015.76.2.C28. PMID: 25667104.
Q.
Could It Be Fetal Alcohol Syndrome? The Reality and Medically Approved Next Steps
A.
There are several factors to consider: fetal alcohol syndrome is the most severe FASD from alcohol exposure in pregnancy and is diagnosed by patterns of facial features, growth restriction, and brain or behavioral differences; early evaluation and intervention improve outcomes. Next steps include speaking with a pediatrician, requesting early intervention and school supports, and seeing specialists, while stopping alcohol in pregnancy and getting help for dependence if needed; important details that can affect your next steps are covered below.
References:
* Popko B, Jurek M, Szajewska H. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, and Developmental Outcomes. J Clin Med. 2021 May 29;10(11):2393. doi: 10.3390/jcm10112393. PMID: 34073350; PMCID: PMC8197793.
* Chudley AE, Popova S, Green CR, et al. Fetal Alcohol Spectrum Disorders (FASD): Updated Clinical Guidelines. J Popul Ther Clin Pharmacol. 2021 May 1;28(2):e2021025. doi: 10.22374/jpstc.v28i2.463. PMID: 34078864.
* Stade L, Ungar WJ, Koren G, et al. Fetal alcohol spectrum disorder: diagnostic and treatment approaches. Lancet Neurol. 2017 Jul;16(7):545-557. doi: 10.1016/S1474-4422(17)30061-X. PMID: 28506540.
* Carmichael Olson H. Fetal alcohol spectrum disorder: A life-span perspective. Dev Med Child Neurol. 2016 Nov;58 Suppl 5:6-12. doi: 10.1111/dmcn.13251. PMID: 27766627.
* Singh SM, Singh S, Choudhary V, et al. Fetal Alcohol Spectrum Disorders: An Overview of Epidemiology, Pathogenesis, and Prevention Strategies. Toxics. 2023 Apr 14;11(4):367. doi: 10.3390/toxics11040367. PMID: 37103986; PMCID: PMC10148191.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Long, D., Long, B., & Koyfman, A. (2017). The emergency medicine management of severe alcohol withdrawal. The American Journal of Emergency Medicine.
https://www.sciencedirect.com/science/article/pii/S0735675717300906Mainerova, B., Prasko, J., Latalova, K., ... (2015). Alcohol withdrawal delirium-diagnosis, course and treatment. Biomedical Papers of ….
https://www.academia.edu/download/39952308/Mainerova_et_al-Alcohol_withdrawal_deliriumBiomedPapers.pdfLaswi, H., Attar, B., Kwei, R., Ojemolon, P., ... (2022). Trends of alcohol withdrawal delirium in the last decade: analysis of the nationwide inpatient sample. Gastroenterology ….
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9451584/