Treatment of alcoholic psychosis (delirium tremens)

The first signs of delirium tremens

The following symptoms may indicate that delirium delirium has begun:

Lack of craving for alcohol. An alcoholic suddenly loses his craving for alcohol and may even experience disgust;
Sudden mood changes. A sign of approaching delirium may be a change from a joyful state to unexpected depression, fear, or melancholy. The person suddenly becomes agitated and cannot sit in one place for a long time;
Insomnia, restless sleep, including nightmares. After waking up, the patient often experiences terrible visual images or hears non-existent sounds;
Trembling of limbs.

Alcoholic delirium is very dangerous for the health and even the life of the patient and the people around him. In such a state, a person, trying to get rid of obsessive hallucinations or “obeying” someone’s orders, can commit suicide, for example, jumping out of a window, hanging himself, or, on the contrary, rushing to help, as it seems to him, the victim, but in fact only causing harm to him.

During an attack of delirium tremens, a person loses orientation in space and time - he does not know what day it is, where he is, where he should go. Although, it is worth noting that he can provide his name and personal information very accurately.

Between visions, so-called lucid periods occur, when the visions go away and the patient can even talk about them.

The development of the disease occurs in stages and can occur in different ways. Depending on the type of pathology, the treatment regimen and types of drugs for it depend. The following types of delirium are distinguished:

Classical. Symptoms appear gradually; several successive stages of pathology development occur.
Lucid. This type of delirium is characterized by an acute onset of the disease, there are no hallucinations, a delusional state, anxiety, tremors, coordination disorders, and fear are more pronounced.
Abortive delirium. This form is characterized by fragmentary hallucinations, fragmentary, insufficiently formed delusional ideas. The person has severe anxiety. This type can develop into another form of psychosis, and sometimes recovery is noted.
Professional delirium. The development of psychosis begins as in a typical squirrel. Further, delusions and hallucinations are reduced, and repetitive movements that are associated with a person’s work, undressing, dressing, etc. begin to prevail in the clinical picture.
Delirious delirium. This is the next stage, which begins from the professional form, but can sometimes develop from other types of disease. Signs include severe, pronounced clouding of consciousness, somatovegetative disorders, and characteristic movement disorders.
Atypical delirium. Occurs in patients who have previously suffered from other forms of delirium tremens, alcoholic psychosis. This type includes symptoms similar to schizophrenia.

Problems in providing assistance

A delirious patient poses a danger to himself and to others due to the unpredictability of his behavior. The patient may commit attacks on others, suicide, or actions due to hallucinations or delusions.

Attention. It is necessary to exclude a wide range of other diseases that may have similar clinical manifestations: traumatic brain injury, meningitis, tuberculosis, pneumonia, pancreatitis, etc. Healthy alcoholics have been rare in recent years; delirium often develops against the background of an existing illness, making it worse.

Alcoholic delirium: code according to ICD 10

According to the International Classification of Diseases (ICD), the code for alcoholic delirium is 10. This disease is typical for people with stages II and III of alcoholism, that is, abusing alcohol for 5–7 years. This condition is observed 1–3 days after the binge stops or on the 4th dash of the sixth day.

There are known cases of people experiencing delirium tremens as a result of poisoning with surrogate alcohol, even in those who did not suffer from addiction. The problem has become widespread also because the market is oversaturated with all kinds of counterfeits.

Also, if there is a traumatic brain injury or central nervous system disease, a person is more likely to develop delirium. For survivors of alcoholic psychosis, signs of delirium tremens can usually occur with even minor alcohol intake.

As part of the disease and the possibility of a mental disorder, sleep disturbances and anxiety are included. The duration of the acute condition, which is accompanied by confusion of mind, usually ranges from 3 to 5 days. In this case, the situation can develop in different ways.

A person deprived of normal sleep can simply fall into madness, showing inadequacy and danger to everything around him. Symptoms do not differ much across all stages of delirium delirium.

What it is

Alcoholic delirium is a term used by doctors to explain the patient’s condition, which developed against the background of active alcohol intake, and is characterized by psychosis, various vegetative, psychotic and other disorders.

If a person drinks for a long time, he will develop this condition, regardless of gender. There is no connection to gender; the frequency of development of pathology among males and females is approximately equal.

Alcohol withdrawal syndrome with delirium is a type of psychotic disorder that develops when the patient is forced to completely stop drinking alcohol. Another name for this symptom is delirium tremens. In this state, the patient also poses a significant threat to the people around him and to himself, since his adequacy cannot withstand any criticism.

Alcoholic delirium and delirium tremens are conditions that only a specialist can clearly differentiate among themselves. Both conditions can torment the patient for a long time - from a day to several days, and in especially severe cases, up to a week or more.

Important! If, against the background of delirium, a person continues to drink, the symptoms indicating damage to the nervous system will only worsen until they lead to death.

Causes

Alcoholism becomes the main and main factor in the development of pathology. Additional factors include long-term consumption, low-quality alcoholic beverages (technical liquids, alcohol surrogates, pharmacological preparations with alcohol), severe pathologies of internal organs. The following factors can also lead to typical delirium:

Traumatic brain injuries have some significance, as does a history of brain disease.
According to doctors, a decisive role is played by chronic intoxication of the body and metabolic disorders in the brain.
The likelihood of delirium tremens increases due to severe physical and mental stress, for example, if the patient is injured while intoxicated and ends up in the hospital. Alcohol stops entering the body, withdrawal syndrome develops against the background of a change of environment, discomfort and physical pain, and worries about injury.
A situation similar to the situation described above develops when drunken patients are admitted to a hospital department (cardiology, gastroenterology).
At home, delirium develops, as a rule, after a sharp exit from binge drinking against the background of exacerbation of somatic disorders.

Alcoholic delirium is what is commonly called delirium tremens, caused by an abrupt cessation of binge drinking in alcoholics, and also, extremely rarely, by excessive consumption of the “green snake”. A psychiatrist can make this diagnosis only in consultation with a narcologist. The nature of the described mental disorder is always exogenous, that is, it depends on external factors. The causes of psychosis are divided into three groups:

Delirium in diseases of the central nervous system - meningitis, epilepsy.
For somatic systemic diseases - renal, pulmonary, heart failure.
With long-term constant intoxication of the body - alcohol, drugs, medications.

Signs of alcoholic delirium begin long before the actual attack, sometimes several days. The patient abruptly stops drinking alcohol, saying that he is no longer interested in alcohol; his mood changes, then trembling in his limbs and hallucinations occur. Then, closer to midnight, alcoholic delirium sets in directly with immediate manifestation and dynamics.

Delirium in alcoholism is characterized by the following symptoms:

General aggressive state.
Hallucinations.
Memory loss (partial: the patient remembers his personal data - birthday, last name - but forgets the simplest things about loved ones, even the names of relatives, may forget his place of residence).
Tremor (shaking in hands, knees).
Incoherent speech, jerky sentences, delirium.
Disorientation, loss of sense of time and space.
Sweating, fever, pallor, chills, blood pressure.

Content:

General description.
The course of a typical alcoholic delirium: 2.1. Initial stage. 2.2. Expanded stage. 2.3. The final stage. 2.4. Associated symptoms.
Other forms of alcoholic delirium.
Principles of treatment.

One of the most severe consequences of long-term binge drinking is psychosis, accompanied by disturbances of consciousness, hallucinations and other symptoms. And one of the most common forms of this disorder is delirium tremens (its better known name is delirium tremens), which requires mandatory hospitalization and intensive treatment with the use of potent neuroleptics and other medications.

Symptom relief

The main symptom of delirium tremens is hallucinations. An attack of delirium tremens in most cases occurs at night and is characterized by a progressive nature. Hallucinations are dominated by images of small animals, insects and amphibians, for example, rats and mice, snakes and spiders. Most often, those whom a person in a normal state fears, and in the old days, believing alcoholics imagined devils.

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There may also be visions of ropes, nets and cobwebs from which a person cannot get out, or “scenes from horror films.”

Auditory hallucinations are manifested by the fact that the patient hears screams of horror, animal cries, threats, and name-calling addressed to himself.

Cases of painful, often unfounded, jealousy are not uncommon during delirium tremens.

All symptoms of alcoholic delirium are noticeable to others, as they are reflected by the alcoholic’s facial expressions. Grimaces of horror, confusion and fear appear on his face. He tries to hide, pushes someone away from him, throws off imaginary reptiles. With tactile hallucinations, a person feels these insects crawling or biting him, beating him or cutting him, etc.

Alcoholic psychosis is characterized by the sensation of a foreign body in the mouth - they try in every possible way to pull it out with their hands or spit it out.

The speech of an alcoholic during an attack is slurred and intermittent - he talks to images of his visions, shouts out individual words or remarks.

Somatic symptoms of alcoholic delirium include:

Tremor;
Hyperemia;
Increased body temperature to 39 degrees;
High arterial hypertension (can reach 160-180/mmHg);
Increased sweating;
Strengthening tendon reflexes.

In this case, the work of all or almost all internal organs is disrupted.

Typical alcoholic psychosis lasts from 3 to 5 days. The first positive sign of recovery from it is an improvement in the quality of sleep.

Alcoholic delirium most often develops 2-3 days after stopping alcohol intake. A harbinger of the main symptoms of alcoholic delirium can be sleep disturbance. Restless sleep, accompanied by nightmares, does not lead to rest. Symptoms such as headache, nausea, vomiting, speech impairment, etc. may also appear. However, they are not specific and most often accompany any withdrawal syndrome.

-psychotic;

-vegetative;

-organic brain damage.

Early symptoms of alcoholic delirium are anxiety, a feeling of inexplicable threat, and fear. General somatic symptoms appear: increased sweating, trembling hands, rapid heartbeat, high blood pressure. Sleep disturbance gradually turns into insomnia. The patient is haunted by vivid auditory and visual hallucinations.

During alcoholic delirium, the patient may “hear” voices ordering him something, scolding him, calling him names, teasing him. The person's behavior becomes inappropriate. He is completely captivated by hallucinations: he “talks” with someone, screams, tries to run away, “catches” “insects” on himself and his clothes, etc. Sometimes boastful behavior appears: in a state of excitement, the patient talks about his “exploits.”

The state of excitement can be replaced by periods of imaginary well-being, during which behavior becomes more calm and adequate. However, after a short period of time, the symptoms of delirium tremens resume.

Somatic symptoms in a fully developed clinical picture of delirium tremens include: hyperthermia (up to 38-39 °C), high arterial hypertension (160-180/110 mmHg), tremor, increased tendon reflexes, increased sweating. The work of all internal organs is disrupted.

Typical alcoholic delirium lasts 3-5 days. The first positive symptom of recovery from delirium tremens is improved sleep.

Signs of the disease can be of two types, that is, mental and somatic. Their manifestation occurs in a complex, so the doctor makes an accurate diagnosis, identifying the original cause. The main symptoms of alcoholic delirium are as follows:

From a mental point of view:
obsessive, delusional ideas and anxiety;
panicky feeling of fear;
various hallucinations;
increased degree of arousal;
temporal-spatial disorientation.
From a somatic point of view:
increased heart rate and blood pressure. Body temperature up to 39–40 °C;
headache, nausea (including vomiting), shortness of breath;
periodic seizures;
flushed face.

Delirium tremens is easy to distinguish by hallucinations. It’s not for nothing that many people say about a person that he “got drunk as hell,” and this is by no means a joke. Alcoholics can actually see animals and insects crawling on their bodies or characters from fairy tales.

The imagination of an alcoholic can be unpredictable, because, in addition to visual hallucinations, he imagines touching. In the process of fighting imaginary devils, the patient seeks to injure himself, but is not aggressive towards strangers.

Another common disorder is a disruption in water-salt homeostasis, which occurs due to changes in metabolism as a whole. Long-term heavy drinking contributes to a significant increase in the concentration of ethanol in the blood, so the body has to mobilize its own strength. As a result, the metabolic process in the body occurs with reduced intensity. Interruptions in the functioning of internal organs begin, and death is possible.

There are two main types of signs of the development of the disease - somatic and mental. They usually appear together, so doctors are almost 100% guaranteed to make the correct diagnosis. The most striking sign is hallucinations; in reality, a person observes various insects, animals or fantastic creatures.

Physiological

This is one of the types of symptoms that are inherent in alcoholic psychosis. This group includes signs of pathology that are of a direct physiological nature. The following key symptoms of this type are identified:

sweating;
hand tremors;
facial redness;
limbs are cold;
Heart rate over 100 beats;
dyspnea;
Blood pressure rises to 180/100;
vomit;
body temperature rises to 40 degrees;
convulsions;
headache.

This group of symptoms is associated with delusional disorders and serious brain damage. They appear simultaneously with physiological symptoms and form a complete picture of delirium. This group includes the following manifestations:

rave;
insomnia, nightmares and other sleep disorders;
tactile, auditory, visual hallucinations;
anxiety;
panicky feeling of fear;
disorientation in space and time;
excessive excitement.

As soon as clinical manifestations of alcoholic hallucinosis are noticed, an ambulance should be immediately called to hospitalize the patient. For treatment, a person is sent to a drug treatment or psychiatric clinic, where he can receive the necessary observation and drug treatment. Before the ambulance arrives, it is necessary to place the patient with characteristic mental symptoms in bed and maintain this position for as long as possible. When treating alcoholic delirium, a person should not be left alone for a second.

Stages of development of delirium

Getting out of painful madness on your own is quite problematic, especially if it has reached a late stage. When describing alcoholic delirium, the development and types of the disease, doctors distinguish the corresponding stages:

First:
normal state of consciousness and personality as a whole;
return to normal without medical assistance.
Second: delirium accomplished
inability to study independently;
transition to stage III if no therapy was performed.
Third: threat to life
slurred speech;
decreased response to external stimuli, blood pressure and pulse;
the person is no longer aware of himself.

1. Threatening delirium.

Common symptoms of alcohol withdrawal are common. The patient may have all the symptoms described earlier, but the severity is insignificant. In a deployed clinic, disorientation in time and space may appear, but awareness of one’s own personality remains. Body temperature does not exceed subfebrile levels. This stage is reversible and can end arbitrarily.

2. Complete delirium.

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All symptoms are pronounced. Auditory, visual and tactile hallucinations increase. Delusional experiences arise, often of an unpleasant nature. The general somatic condition worsens: shortness of breath appears up to 22-24 breaths per minute, blood pressure (blood pressure) and pulse increase. At this stage, spontaneous resolution of alcoholic delirium is impossible. Without timely assistance, this stage quickly progresses to stage 3.

3. Life-threatening delirium.

All mental symptoms persist along with obvious aggravation of somatic ones. Lethargy appears, speech is slurred, quiet (mumbling), and the reaction to external stimuli decreases. Blood pressure drops sharply, pulse filling weakens, shortness of breath becomes more frequent. Depression of consciousness gradually increases to the point of coma. At this stage, irreversible changes in internal organs and systems can occur, decompensation and, possibly, death occur.

In the later stages of the disease, it is practically impossible to recover from alcoholic psychosis on your own; this condition requires medical attention. There are several stages of the disease that have specific characteristics. The treatment regimen is prescribed taking into account the patient’s condition, so this is an important diagnostic point. The main stages of the development of alcoholic psychosis (delirium) are described below.

Initial

At the first stage, characteristic disturbances in a person’s emotional state are noted. It changes quickly, worry and anxiety are immediately replaced by high spirits, euphoria, then despondency and depression may set in. The patient’s facial expressions and speech remain alive, so the person simply looks worried and nervous. This stage is characterized by the following manifestations:

Any irritants cause an acute reaction: smells, sound, flashes of light.
The patient will talk about vivid memories and images that pop up in his mind.
Fragmentary visual and auditory hallucinations are noted.
At night, a person feels severe anxiety, often wakes up, and has shallow sleep.

This is the stage of complete delirium, when all the symptoms of the disease become more pronounced. The following signs of alcoholic psychosis are noted:

Full-fledged visual hallucinations, auditory and tactile hallucinations are added, in some cases even thermal, olfactory and gustatory.
It seems to a person that they are trying to kill him, that someone is chasing him.
Visual delirium manifests itself in the form of spiders, midges, cobwebs flying around the room, and sometimes images of deceased loved ones appear.
A person feels rats, snakes, small insects crawling on the skin - these are tactile hallucinations.
The above symptom leads to an increase in body temperature, heart rate, and blood pressure.
If the patient has concomitant pathologies, for example, depression, severe trauma, or previous delirium, then the second stage quickly progresses to the third.

This is the final stage of the disease, which requires hospital treatment. Medicinal and physiotherapeutic methods are used for therapy. True delirium has the following symptoms:

The patient ceases to respond adequately to external commands, speech is incoherent and quiet.
There is a decrease of 20% relative to normal blood pressure.
Frequent convulsions occur, the pupils are dilated, breathing is intermittent, trembling occurs throughout the body.
The muscles of the back of the head stop deforming.
In severe cases, the patient falls into a coma, and swelling of the brain tissue may occur, which leads to death.
There is an irreversible disruption of the functioning of many internal organs.

Diagnosis of delirium

Narcologists and psychiatrists work together to make a diagnosis:

examine the skin and mucous membranes for changes in color and increased sweating;
they ask you to stretch your arms forward to check for tremors and convulsions;
examine the pupil width and fundus for pressure;
a general urine test to determine the presence of inflammatory processes in the body (based on the level of released protein) and dehydration;
general and biochemical blood test to determine ESR, electrolytes, deficiency processes;
conduct a survey of the patient to check the coherence of speech and the presence of hallucinations and delusions (to distinguish with depression).

Be sure to interview relatives.

The doctor finds out when and how the first symptoms appeared, whether they were:

vomit;
insomnia;
nightmares;
sudden change of mood;
aggression;
anxiety.

This is necessary to distinguish delirium from senile dementia and bipolar disorder.

Traditional test questions for emergency diagnostics are shown in the photo.

Emergency test
If the patient scores less than 23 points, then doctors raise the question of the development of alcoholic delirium.

Diagnostic nuances

Doctors monitor for the following symptoms:

tremor of the body and limbs;
sudden changes in blood pressure;
increased heart rate and breathing;
elevated body temperature.

Alcohol delirium - treatment

This condition requires not only intensive drug therapy, but also constant monitoring of the patient to ensure the safety of himself and those around him. In some cases, resuscitation measures are needed to provide emergency care. Treatment of delirium must be carried out on the basis of a psychoneurological hospital, under the supervision of a therapist or resuscitator.

Self-medication of withdrawal symptoms is strictly prohibited. An experienced doctor will be able to correctly select the list of necessary medications that will bring the patient’s condition back to normal. If the scheme is drawn up incorrectly, complications may develop. In the hospital, the following groups of medications are usually used to treat delirium:

psychotropic drugs;
means for normalizing the respiratory system;
preparations for water-salt balance;
phenotisines for adjusting blood pressure;
remedies for insomnia;
medications to normalize metabolism;
drugs to improve the functioning of the cardiovascular system;
detoxification medications.

Alcohol intoxication continues to poison the body, so it is necessary to cleanse the blood and internal organs of poisons. Against the background of alcoholism, a person often develops heart failure, damage to the liver, kidneys, and gastrointestinal tract is observed. To cleanse the body, intravenous administration of medications such as Piracetam or Unitol is often used. If mental disorders are identified during diagnosis, then antipsychotropic drugs (Renalum, Tezapam) are used.

An effective method of cleansing the blood of alcohol toxins is plasmapheresis. This is a method of plasma purification; part of it is replaced with special solutions. This helps to achieve maximum detoxification action, which clears the cells of poisons that cause withdrawal symptoms. Plasmapheresis has the following advantages in the treatment of delirium:

normalization of brain nutrition;
improvement of rheological properties of blood;
high safety of the procedure;
normalization of the immune system;
reducing the duration of treatment for alcoholism;
tangible relief of the patient’s condition during severe abstinence;
relieving the load on the liver;
the risk of exacerbation of pathologies of internal organs is reduced during the treatment of delirium and abrupt withdrawal of alcohol intake.

For these purposes, medications from the benzodiazepine group are used, which are the basis for the treatment of delirium. In medicine, they are recognized as the safest, most effective medications for therapy at all stages of alcoholism. The dosage is selected individually so that the patient is relieved of all the main signs of alcoholic psychosis, but does not experience depression of spontaneous breathing. These medications help put a person into a state of prolonged sleep if necessary.

In Russia and the CIS countries, Diazeam is more often used, and sometimes phenazepam. In most countries, Lorazepam is considered the safest and most effective, especially if the patient is diagnosed with liver disease. The use of sufficient initial doses of this group of medications helps to avoid severe agitation of a threatening nature. The traditional dosage regimen for benzodiazepines is as follows:

A bolus of 2 mg of Phenazepam or 10 mg of Diazepam is administered 3-6 times a day.
Combine benzodiazepines with antipsychotics due to insufficient antipsychotic effect.
When the required sedative effect is achieved, the administration of the drugs is stopped. This avoids depression, respiratory arrest and hypotension.

This is another main group of medications that is used in the treatment of alcoholic psychosis. In modern practice, it is used as additional measures when the above-described means are insufficiently effective. This is due to a number of disadvantages of these drugs: they cause hypotension and reduce the threshold for convulsive readiness.

Pereziazine;
Propofol;
Benperidol;
Dexmedetomidine;
Clozapine.

Cardiac glycoside

This is a group of drugs that are of plant or synthetic origin and are aimed at improving cardiac function. As a rule, they are used in the treatment of severe cases caused by impaired myocardial contractility. It manifests itself in the form of wheezing and shortness of breath.

This is one of the most terrible complications, which without treatment can be fatal. Therapy begins after the acute condition, psychosis, is relieved. The following medications are used to treat alcoholic encephalopathy:

neuroprotectors: Actovegin, Cerebrolysin;
nootronics: Elkar, Cavinton, Pantogam;
sedatives: Relanium, Phenazepam;
treatment of alcohol abuse: Colme, Teturam, Esperal.

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Delirium tremens is a condition that not only requires monitoring of the patient in order to ensure the safety of himself and those around him, but also requires fairly intensive drug therapy. In some cases, even resuscitation measures are necessary. It is advisable to carry out treatment of alcoholic delirium on the basis of a psychoneurological hospital with the mandatory involvement of a resuscitator and therapist.

Many drugs have been proposed, but at the moment there is no single point of view on the algorithm for the treatment of alcoholic delirium.

In Europe, the standard treatment for alcoholic delirium is clomethiazole. In Russia and the USA, benzodiazepines have been and remain the drugs of choice. Their disadvantages include respiratory depression and accumulation of sedation.

In most cases, the treatment for alcoholic delirium is intravenous combination therapy with benzodiazepines and haloperidol (or droperidol).

In parallel with the relief of mental symptoms, all intensive measures aimed at eliminating somatic disorders are indicated for the treatment of alcoholic delirium. When prescribing all drugs, it is necessary to remember the degree of their influence on the nervous system and the possibility of prescribing this group to patients with chronic alcoholism.

Treatment of alcoholic delirium does not occur at home, since the patient must be hospitalized in a psychoneurological hospital. There is no single medical opinion on this matter.

In European countries, the well-known drug clomethiazole is becoming an effective solution. In Russia and the USA, treatment is based on substances belonging to the group of benzodiazepines. The drugs are characterized by a pronounced psychoactive effect and a decrease in excitability in patients. An increased dosage helps a person fall asleep soundly.

In order to establish water-salt homeostasis, drugs called sodium bicarbonate and rheopolyglucin are used. To eliminate pulmonary and cerebral edema during treatment, specialists use mannitol. Vitamins belonging to groups C, PP and B are required for indication.

The use of medications belonging to a different type depends on the symptoms. In any case, the course of therapy is prescribed exclusively by the attending physician. It is highly recommended not to try to get rid of delirium tremens on your own. By self-medicating and not calculating the dosage, you can only cause harm to yourself. Also, if you do not have a prescription in hand, the drug will not be sold.

Treatment for delirium tremens is usually compulsory. The patient's relatives are forced to take this step at the request of the relatives. The treatment process is carried out by qualified doctors. In this case, the situation is developing in three possible directions.

The weakened body of a person who regularly drinks alcohol is weakened, and additional drug-based therapy can have a negative impact on it. However, leaving the patient in a state of madness is dangerous for the lives of those around him.

Upon reaching the third stage of delirium tremens, the case is highly likely to end in death. Therefore, it is better to try to save a loved one, even taking a conscious risk.

Delirium tremens is a condition that requires immediate medical attention as it can lead to death.

In the treatment of alcoholic delirium, psychotropic and detoxification drugs are used, as well as drugs that normalize water-salt balance, metabolism, cardiac activity and respiration.

To relieve psychomotor agitation, seduxen, diphenhydramine or sodium hydroxybutyrate are administered.

Of the psychotropic medications in the treatment of alcoholic delirium, Relanium, droperidol or haloperidol are most often used - they temporarily suppress agitation and hallucinations.

In order to eliminate intoxication of the body, intravenous drips with glucose, hemodez, rheopolyglucin are placed, and hemosorption is carried out.

Vitamins are also prescribed, and the activity of the heart is supported with the help of corglycone and cordiamine.

Since alcoholic delirium is characterized by a highly agitated state, attacks should not be stopped at home. Treatment takes place in intensive care, a drug treatment clinic or a mental hospital and lasts about a week, sometimes less. To begin with, intoxication is carried out, and there are three stages of treatment:

Sanitary supervision: placement in a ward with daylight (strong lighting is an irritant, and darkness increases delusions and hallucinations), isolation from society. Treatment is aimed at eliminating excitability and insomnia, because normalization of sleep is the main sign that the patient is being cured.
Relief of agitation using benzodiazepine medications, which are tranquilizers. Medicines are given in large doses.
The use of medications to maintain heart function: from ascorbic acid and glucose to nicotinic acid, depending on the complexity of the case.

Principles of treatment

Therapy must be carried out in a hospital; full treatment at home is simply impossible. Basic goals:

elimination of insomnia and psychomotor agitation;
maintaining cardiovascular activity;
replenishment of fluid and nutrient deficiency;
correction of electrolyte balance;
prevention of cerebral edema.

For this use:

strong sedatives (neuroleptics, barbiturates);
antiarrhythmic drugs, drugs for normalizing blood pressure;
infusion solutions of electrolytes;
diuretics;
B vitamins, ascorbic acid, folic acid;
corticosteroids;
nootropics.

Physiotherapy procedures have a good effect: hemosorption, plasmapheresis, ILBI. As the patient’s condition normalizes, the treatment regimen is changed: the dose of sedatives is reduced, instead of injections, tablet forms of drugs are selected, intended for a long recovery course.

But it should be taken into account that after the first attack, episodes of alcoholic delirium develop faster and occur more often. This is fraught with irreversible personality changes and severe mental disorders. Therefore, comprehensive treatment of the disease is necessary, with mandatory complete abstinence from alcohol.

Consequences of alcoholic delirium

Alcoholic delirium develops due to the consumption of alcohol, which is a toxin that is poisonous to the body. If binge alcoholics take a break from drinking, they will experience delirium tremens. This disorder causes various diseases, including fatal ones. The consequences of delirium are as follows:

Cardiomyopathy (fatal in almost five percent of cases).
Pneumonia.
Kidney failure.
Pancreatitis.
Brain swelling.
Salt imbalance.

Abrupt refusal during pathological intoxication from drinking alcoholic beverages leads to dangerous consequences. The most dangerous complication is cerebral edema, which leads to death. This can only be avoided with timely diagnosis and medical care. Delirium tremens becomes a catalyst for the development of various diseases, for example:

pancreatitis;
pneumonia;
renal failure;
alcoholic cardiomyopathy;
rhabdomyolysis;
violation of vitamin metabolism;
failure of water-salt balance;
acid-base disorders;
cerebral edema.

Alcoholic delirium is fraught with disruptions in the functioning of all major organ systems. Among the most common complications:

inflamed pancreas or lungs;
impaired heart function;
the appearance of swelling of the brain;
kidney failure.

This is just a small list of the consequences of delirium alcoholism. It is important that assistance is provided in a timely manner and that chronic diseases of the kidneys, liver, etc. do not develop.

The manifestation of delirium tremens in chronic alcoholics, as a rule, occurs after the end of the binge. You can recognize a “squirrel” by hallucinations that can drive an unhealthy and inadequate person to self-harm.

In order to overcome the disorder, you can use medication. However, treatment cannot always save the patient and lead to complete healing. Therefore, if possible, it is better not to succumb to alcohol addiction.

Forecast and consequences

The prognosis for delirium delirium depends on how quickly therapy began, the degree of damage to internal organs, the state of the central and autonomic nervous system, and the age of the patient.

The consequences of delirium tremens after a binge for the patient can be disastrous. In delirium, a person can commit suicide or seriously injure himself or others. The patient risks dying from cerebral edema and alcoholic myocardiopathy. After the attack subsides, the patient may experience persistent memory impairment, amnesia, mental or psychoorganic disorder, damage to internal organs: pancreatitis, liver, kidney failure, anemia, partial paralysis.

Delirium tremens

It is a mistake to believe that relapse of the disease can be avoided by reducing libations or making them more rare. Experienced delirium is a clear sign of the development of alcoholic encephalopathy and associated irreversible brain damage. After suffering from delirium tremens, a second attack can be prevented only by a complete lifelong refusal to take any doses of alcohol.

Sanitary supervision

This is a mandatory condition when treating a patient with obvious signs of alcohol withdrawal due to chronic alcoholism. With abrupt cessation of use, disturbances of consciousness are observed. Attacks of delirium are accompanied by autonomic disorders and delusions of persecution, and are characterized by visual hallucinations that are at odds with reality.

Deep sedation will be performed, and the patient will be connected to a ventilator until the episodes of delirium end.
The person remains on spontaneous breathing; acute psychosis is relieved with the help of medications.

Who's at risk

Alcoholic delirium is characterized by development only in those patients who systematically abuse alcohol. That is, people whose alcoholism has long crossed the boundaries of stages 2-3 are at risk. The risk of developing pathology increases significantly if the duration of systematic consumption of alcoholic beverages exceeds 10-15 years without interruptions.

In some cases, the reasons for the development of alcohol lie in the long-term use of a harmful substance by a person who was previously not inclined to drink a lot, or in the use of surrogate alcohol, which caused poisoning. However, in these cases, alcohol poisoning may develop more quickly than a delirious state, which must be kept in mind.

With chronic alcoholism, the risk of developing a pathological condition increases significantly if the patient has previously had a variety of traumatic brain injuries, pathologies of the nervous system, or any mental illness. Also, the risks increase significantly if, after one episode of delirium, a person continues to actively drink, without responding to doctors’ recommendations to give up his addiction.

The question often arises about why people drink to such a state. There can be many reasons. Someone is trying to escape from problems in this way, someone has developed a real mental dependence on the “green snake”, and for others the addiction has acquired physiological characteristics. To combat a negative state, it is necessary to understand who is at risk and what are the possible reasons why a person starts drinking. By assessing them, appropriate treatment can be selected and the patient can be encouraged to give up alcohol before he or she develops delirium tremens.