Tablets for delirium tremens. Delirium tremens: what treatment is possible? Herbal tea against delirium tremens

Alcoholic delirium or, as this condition is popularly called, delirium tremens is psychotic disorder, which occurs in people suffering from alcoholism after withdrawal from alcohol. In ICD 10, the disease is classified under F10.4 and is defined as an abstinence state with delirium. Treatment and diagnosis of the pathological condition falls within the competence of psychiatrists and narcologists.

It is worth noting that delirium tremens can occur not only in chronic alcoholics. Signs of this condition may well appear in men and women who do not drink alcohol often and in large doses, but have drank, for example, low-quality alcohol, called surrogate. In addition, the risk of developing alcoholic delirium increases in people with serious pathologies of the central nervous system. nervous system and those who have suffered traumatic brain injuries. It should be noted that the consequences of the first attack can become quite severe, and in the future it is possible that episodes of delirium tremens may recur when taking even small doses of alcohol.

Causes

The main reason why most people develop delirium tremens lies in severe alcoholism. An acute attack can occur if long-term binge drinking and alcohol withdrawal are stopped. At the same time, delirium tremens does not occur in a state of intoxication; its first manifestations begin several days after taking the last dose of alcohol. Severe hangover is a predisposing factor to the development of the described disease.

In some cases, delirium tremens also occurs in people who do not suffer from alcoholism, but who have taken a large dose of alcohol. Other reasons for the development of the pathological condition include organic lesions brain, under the influence of ethanol, a strong neurotoxin. The risk group also includes people with severe somatic diseases.

Stages and manifestations

Typically, delirium tremens, which appears for the first time, is interpreted by doctors as the second stage of alcoholism, when a person has obvious physical and mental dependence from alcohol. Alcohol delirium has three stages:

Korsakov psychosis. The first stage of alcoholic delirium, in which alcoholics fully manifest sleep, memory and mood disorders;
Rave. A mild form of psychosis, characteristic of most chronic alcoholics. Characterized by the absence of any forms of hallucinations;
Severe third stage. It manifests itself as various neurological disorders and is considered “full-fledged” delirium tremens.

Treatment, as a rule, is prescribed by a doctor depending on at what stage the patient is diagnosed with delirium tremens. Its symptoms can be quite varied and include a number of different psychotic and somatic disorders:

All these symptoms clearly indicate that a person is experiencing delirium tremens, which is much easier to combat in the absence of severe alcohol addiction. In any case, only timely, qualified treatment will help to avoid complications and normalize the condition of an alcoholic.

Korsakov psychosis

This type of psychosis was first described at the end of the nineteenth century by psychiatrist Korsakov,
who believed that similar condition develops predominantly in people over forty years of age who suffer from third-degree alcoholism. With Korsakov's psychosis, damage to the peripheral nervous system occurs and various mental disorders are observed.

Thus, a similar pathological condition that characterizes delirium delirium is manifested primarily by impaired memory function. An alcoholic is unable to remember events that took place very recently, does not remember the names of places and people, and experiences disorientation. Manifestations of increasing anxiety and depression are also expressed.

Neurological manifestations of Korsakoff's psychosis include pain nerve trunks, sensory impairment and tendon reflexes. IN neglected form the pathology leads to paralysis, which in some cases is not reversible.

Hallucinations

Most people associate delirium tremens with hallucinations, which occur in patients mainly at night. Most often, the patient is haunted by visual images of those creatures or objects of which he feels fear when sober. Sometimes entire scenes from horror films unfold before a person’s eyes.

You can suspect hallucinations in a patient by his facial expressions, since they reflect his emotions and experiences. Behavior at this time also becomes inappropriate - a person can shake off spiders that are only visible to him, brush away insects, etc. In addition to visual images, alcoholics in a similar state may experience tactile and auditory hallucinations. They are able to sense being foreign object in oral cavity, mosquito bites, non-existent itching, and also enter into dialogue with the object of your own visions. In such a state, the patient becomes truly dangerous, since the voices in his head can force him to do literally anything.

Complications

Delirium tremens, characterized by serious clouding of reason, poses a serious threat both to the victim himself and to his loved ones. The consequences of such a condition can be very sad, because alcoholics, without realizing it, are capable of causing serious harm to loved ones, trying to somehow get rid of obsessive images or commit suicide.

In addition, this condition negatively affects the functioning of almost all body systems. The most common effects of delirium tremens include alcoholic hepatitis, stomach bleeding, digestive disorders. Since during the period of alcoholic delirium there is a weakening immune system, the patient increases the risk of developing infectious diseases and exacerbation chronic pathologies. The most severe complication in the absence of timely therapeutic assistance, death can occur.

Help at home

Experts say that you cannot treat delirium tremens at home and get rid of the pathology without consulting a doctor, but you need to know what to do when an attack occurs and provide first aid to the patient when an attack begins. First of all, you should bring the person to horizontal position, laying him on his back. If necessary, the patient can be tied to bed so that he does not cause harm to himself and others. You need to put an ice compress on your forehead or provide cold shower. To prevent dehydration, drink as much water as possible.

Will help relieve the patient's agitation sedatives. It is very important not to leave the person alone, but to ensure constant control. In the future, it is recommended to immediately seek medical help, as delirium delirium is a serious disorder that should be treated as soon as possible.

Therapy

The question of how to prevent and treat delirium tremens is quite acute for relatives of people suffering from severe addiction to alcohol. Treatment of alcoholic delirium is carried out in inpatient conditions under the supervision of a narcologist and psychiatrist. The attack can be controlled with a number of medications. If treatment is not started in a timely manner, the consequences can be dire, including death.

Among the entire arsenal of drugs used in the treatment of delirium tremens, psychotropic and detoxification drugs, as well as drugs that help restore water-salt balance and metabolism, come first. Besides, complex treatment involves restoring the activity of the cardiovascular and respiratory systems.

Detoxification is especially important in this pathological condition. To remove toxic substances from the patient’s body, causing manifestations delirium tremens, doctors use droppers with hemodez and glucose, and perform hemosorption.

Delirium tremens is an acute psychosis that is dangerous for the patient and his loved ones. It occurs most often in chronic alcoholism after a sudden cessation of alcohol consumption. In most cases, delirium tremens occurs in people with suffered trauma head or heavy infectious disease. Treatment of delirium tremens at home is possible only at the first stage, then the patient must undergo therapy in a hospital under the supervision of doctors.

At the first signs of alcoholic delirium, it is worth providing first aid to the patient. Treatment at home should begin when the following symptoms delirium tremens:

strong headache, nausea and vomiting;
incoherent speech;
convulsions;
mental agitation, mood swings, anxiety;
sleep disturbances, nightmare visions in sleep;
increased sweating, temperature increase;
trembling of limbs, facial muscles;
increased blood pressure and rapid heartbeat;
change in complexion, tongue, yellowing of eyes.

Also pronounced are auditory and visual hallucinations. The patient may have visions of scary images, insects, and people. Behavior becomes inappropriate, he tries to get rid of obsessive hallucinations. Voices often appear in the head, leading to suicide or murder of other people. Men are overcome with intense anger and jealousy; they suspect everyone of conspiracy and persecution. The patient becomes aggressive and dangerous to his environment. Women often become depressed, but they can also show aggression and do not control their actions.

Treating delirium tremens at home

How many days does delirium tremens last after drinking?

The condition can last from 3 to 7 days, sometimes more. At the first attack of delirium tremens, the person must be given urgent help. You should not give him medication right away; he needs to be calmed down and placed in a horizontal position. Then call ambulance and admitted to hospital.

What to do at home during delirium tremens:

The patient must be put to bed and reassured. If a person is aggressive and behaves inappropriately, it is worth tying his arms and legs securely. Remove from him all foreign objects that could injure him or harm other people.
Provide the patient drinking plenty of fluids and coolness. You can put it under a cold shower, or place a compress with ice or a damp bandage on your forehead. Change compresses as they warm up.
The patient must take sedatives : Piracetam, Diphenhydramine. He needs to calm down and fall asleep. You can give decoctions from medicinal herbs: chamomile, lemon balm, sage. They normalize sleep and relieve anxiety.
The patient can be calmed by talking quietly. You should not quarrel and blame him, since he does not understand what is happening in reality. Relatives need to treat the patient with understanding and care. Your support is extremely important.
Call an ambulance immediately. Treating delirium tremens at home is undesirable and dangerous. Without adequate therapy, the patient will not be able to cope with this condition. He can be harmed.

How to treat and cure delirium tremens at home? It is impossible to do this without a doctor. Many drugs cannot be purchased at a pharmacy without a prescription, and some of them can be harmful to health and lead to death. The patient needs full treatment in a clinic under supervision experienced specialists. He must give up alcohol completely. Since delirium tremens contributes to the destruction of the entire body, a person must take drugs to restore organs. Therapy can be prescribed only after diagnosis.

Treatment of delirium tremens in a hospital

Can delirium tremens go away on its own? No, It is Immpossible. This condition must be stopped, otherwise the consequences can be tragic. In most cases, the patient is placed in a psychiatric hospital where treatment is carried out. This is necessary so that he does not commit suicide or harm others. The patient needs constant monitoring and supervision by doctors. After the attack of delirium tremens has stopped, he is shown comprehensive psychotherapy.

At the clinic, the patient is given medications to relieve symptoms: sibazone solution, sodium hydroxybutyrate and others. The patient is immediately placed in mental asylum to restore the nervous system and calm. He is prescribed sleeping pills and sedatives, isolation from others, and protection from psychosis. An effective remedy for the treatment of delirium tremens is the recommendation of doctor E.A. Popova: phenobarbital (luminal) 2-3 tablets, medical alcohol 10-20 g, distilled water 100 ml. Everything is mixed well and given to the patient in one dose. Phenobarbital may be replaced by another strong sleeping pill.

After the patient has calmed down, a comprehensive detoxification of the body is carried out - alcohol breakdown products are removed from the blood, breathing and heartbeat are normalized. Stabilized with the help of tranquilizers, drugs and vitamins water-electrolyte balance and metabolism is restored. To restore strength, glucose preparations are administered intravenously. Doctors need to normalize mental condition patient, eliminate insomnia and restore good dream. The patient is shown complete rest and rest. After this, you can begin treatment for alcohol addiction, sessions with a psychotherapist.

Treatment of delirium tremens at home is not only ineffective, but also dangerous for the patient and his loved ones. Can't be picked up necessary medications, it is extremely difficult to calm an alcoholic in an attack of psychosis. This can lead to dire consequences. The patient must be under constant control doctors to avoid complications. After eliminating the attack of delirium tremens, he is shown compulsory treatment from alcoholism, restoration of the nervous system, complete cessation of alcohol. IN otherwise delirium tremens can recur and be fatal.

Alcohol addiction affects many drinking time from people's time. Unfortunately, the disease is rarely detected on early stages. Often an alcoholic long years either hides his addiction from loved ones, or denies its existence, refusing to consult a specialist. In both cases, the patient does not receive timely medical care. As a result, chronic alcoholism is formed. One of characteristic complications chronic alcohol dependence are attacks of delirium tremens.

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Delirium tremens, which official language medicine is called alcoholic delirium, is an acute alcoholic psychosis that occurs in alcoholics after leaving drunken state. Typically, this condition is typical for a patient in the second and subsequent stages of alcohol dependence. This disorder is preceded by long-term alcohol abuse, which leads to somatic pathologies, headaches, sleep disorders, general ailments, etc.

The clinical picture of delirium tremens is quite bright. From the outside, this condition looks very unpleasant, since the patient is tormented by distinct realistic hallucinations, he loses temporal and spatial orientation, is unable to control himself and is aggressive towards others. In other words, the person behaves like crazy. Let us dwell on the specific manifestations of this disorder.

So, recognizing the pathology is not difficult. An attack of fever is accompanied by the release from the subconscious of all the fears an alcoholic has, which are under control when sober. After heavy drinking, the patient experiences hallucinations in the form of all kinds of devils, witches, sorcerers, and various mythical creatures, enemies, pursuers, killers, any animals, insects, etc. The patient sees all this in reality.

Narcologists consider the first symptoms of delirium tremens to be:

Patient restlessness;
Excessive concern;
Anxiety;
Sleep disorders associated with persistent insomnia;
Moderate hyperthermic manifestations;
Excessive sweating;
Frequent jumps in blood pressure towards hypertension;
Tachycardic symptoms;
Pale skin, up to a bluish tint;
Pathologically low muscle tone;
Ataxic signs;
Reflex hyperactivity;
Dehydration;
Metabolic acidosis, which is characterized by decreased acid-base balance blood;
Excessive content of metabolic products in the body such as urea, creatinine, etc.;
Violations chemical composition blood, etc.

The first manifestations are complemented by the inappropriate behavior of an alcoholic who screams, swears, rushes into empty space and fights with an imaginary opponent. Or vice versa: the patient may run somewhere, as if fleeing from someone. Therefore, during an attack, it often happens that patients jump out of windows, without even thinking about what floor they are on, which often leads to their death.

Persons susceptible to the disease

Of course, people who do not have a tendency to abuse alcohol cannot have delirium tremens. And in people who occasionally drink alcohol, such a disorder is hardly possible. Signs of delirium tremens are usually observed in alcoholics who have a significant history of addiction (more than 5 years) and are approximately at the 2-3 stage of alcoholism.

Typically, fever occurs after a long binge. This condition is provoked by withdrawal syndrome and manifests itself approximately on the second or third day after stopping alcohol, most often at night or in the evening.

However, there are cases when fever occurs in people who once overdid it with alcohol.

How long does delirium tremens last?

Experts distinguish several stages of fever, differing in symptoms and duration:

Threatening delirium (first stage)

Usually occurs in the first 2 days after stopping binge drinking. Clinical manifestations such as hyperthermia, incoherent muttering, hallucinogenic images, tremors and fear, excessive anxiety and fussiness appear in the evenings, although it happens that such signs occur even during the day. This condition lasts about a couple of days, and then goes away on its own. If you drink alcohol at this stage, you can eliminate the symptoms of threatening delirium;

Complete delirium (second stage)

It is dangerous to treat on your own, so the patient requires mandatory hospitalization. Clinical manifestations are striking, and traditional visions are supplemented by tactile and auditory hallucinations. The patient constantly imagines that they want to kill him, that they are persecuting him, that they are weaving intrigues and conspiracies against him. The second stage may last one or two days. If there are pathologies associated with alcoholism (such as severe injuries, cases of delirium in the anamnesis, deep alcoholic depression), completed delirium quickly moves to the next third stage;

Life-threatening delirium (third stage).

At this stage, the patient’s speech becomes incoherent, there is no reaction to others, his blood pressure drops, his pupils dilate, and convulsions appear. muscle contractions. Essentially this is active phase acute psychosis. This condition lasts up to 5 days. This stage is dangerous because the risks of developing comatose state or cerebral edema. In addition, it is at the third stage of delirium that an irreversible disruption of the functionality of most intraorganic structures occurs.

In general, the timing of each stage may shift somewhat and depend on the individual characteristics of the patient and his health, alcohol history and duration of binge drinking.

Treatment

If the patient experiences the first signs of delirium tremens, it is necessary to hospitalize him in a narcological clinic, where he will be provided with the necessary medical care. If delirium is ignored, then there is a high probability that one of these attacks will end for the patient fatal. Especially danger signs indicating the urgent need medical intervention, are convulsive muscle contractions, hyperthermia up to 40°C, excessive aggressiveness, dehydration, high performance Blood pressure and cerebral edema.

After hospitalization, the patient is usually prescribed detoxification therapy, after which the following is indicated:

psychotropic drugs like Haloperidol, Relanium, Droperidol;
drugs to normalize respiratory and cardiac activity (Cordiamin, Korglikon);
means restoring water-salt balance and metabolic exchange.

Detoxification is carried out by infusion therapy, hemosorption, Lasix (1% solution) is administered to prevent swelling of brain tissue. To relieve psycho-emotional overexcitation, drugs like Seduxen, Diphenhydramine, Sodium oxyburate, etc. are recommended.

For alcoholic delirium, therapy is carried out in specialized wards. The duration of fever with qualified therapy usually does not exceed an 8-day period. IN daytime the patient feels well, but at night he begins to suffer from hallucinations. Sometimes all it takes to recover is a long, deep sleep.

Consequences

Delirium causes damage to the entire body, leading to unpredictable consequences. The patient may recover completely or die. The severity of the consequences and outcome of the attack are determined by the strength of health and the degree of ethanol poisoning of the body. In practice, narcologists most often encounter the following consequences of alcoholic tremens:

Severe vitamin deficiency;
Chronic psychoses;
Renal pathologies, cirrhosis, encephalopathy;
Pulmonary inflammation;
Problems with cardiac functions;
Circulatory disorders;
Liver pathologies, failure;
Amnesia;
Dangerous dehydration leading to swelling of brain tissue.

More often, patients who have overcome an attack of delirium fear for their health and try to get rid of addiction forever in order to avoid a relapse of the disease. According to statistics, in such patients, even with small quantity alcohol consumption may occur acute attack delirium, and it will be significantly stronger than the first. In such a situation, it can be very difficult to save the patient, especially with fever against the background of long-term drinking.

Help at home

Treating the symptoms of delirium tremens at home is not recommended, as delirium is considered dangerous condition, capable of causing the death of the patient. Therefore in similar situations You should immediately contact a narcologist-psychiatrist.

Before the doctor arrives, you should try to put the patient to bed. It is necessary to give him more water. If the patient is violent, then even tying him to the bed is acceptable. It is better to apply cold on your head. It is necessary to calm the patient by all means; you can give him valerian, motherwort or some kind of sleeping pill. The main thing is not to leave him alone, so that the patient does not injure himself or others.

If difficulties arise with hospitalization, and for some reason it is impossible, then it is necessary for the patient to fall asleep. For this it is recommended to use sleeping pills, but it is strictly forbidden to mix them with alcohol. At home treatment fever can last from 2 to 20 days. However, to avoid probable complications However, it is strongly recommended to hospitalize the patient in a specialized medical facility to provide qualified care.

Delirium tremens, symptoms, treatment at home

Delirium tremens or delirium delirium is one of the varieties acute form alcoholic psychosis. In this state, the patient is very irritable, aggressive towards others, and may develop hallucinations followed by loss of consciousness, feelings of fear and anxiety.

Some experts distinguish alcoholic delirium as separate disease, others believe that this is just one of the symptoms of strong alcohol intoxication, or rather dependencies.

The pathological condition is observed in people who regularly drink alcoholic beverages in large quantities. Such a patient is very dangerous for the people around him and himself, since he cannot really assess the situation happening around him.

The development of delirium tremens occurs for the following reasons:

sudden refusal to drink alcohol-containing liquids;
previous injuries to the brain and skull;
chronic infectious processes in organism;
excessive alcohol consumption.

The main symptoms of delirium tremens

The first symptoms of delirium tremens begin to appear 72 hours after the patient took the last dose of alcohol. But it is possible that the cancellation arose due to surgical intervention or injury, causing symptoms to begin within 24 hours.

The pathology develops in several stages, and the symptoms depend on this.

Threatening delirium - the first stage

Threatening delirium is very similar to withdrawal syndrome. The clinical picture of the first stage is characterized by:

excessive increase in body temperature up to 40°C;
cardiopalmus;
stomach upset;
disorientation in space and loss of sense of time;
breathing, rapid and intermittent;
urge to vomit;
mild seizures;
paroxysmal headache;
hyperemia skin faces;
speech problems.

These symptoms develop mainly in the morning, and in the evening they can be:

sleep disturbances, with the development of insomnia;
trembling of the upper limbs;
nightmares and horrors;
development of hallucinations.

Acute alcoholic delirium - second stage

Acute alcoholic delirium

At this stage clinical picture begins to increase, it is impossible to recover from delirium tremens on your own. Manifestations of the second stage include:

increased body temperature above 39°C;
problems with sleep begin, patients have nightmares that may seem like reality to them;
breathing becomes more frequent and interrupted;
the patient becomes very mobile and hyperactive;
when exposed to loud sound, bright light and other irritants, the patient’s condition worsens and aggressiveness increases;
hallucinations become more vivid and believable;
the victim picks up any sound and movement - the movement of other people, the closing and opening of doors;
the person thinks that someone is watching him and that he is being pursued.

Delirium tremens develops not only due to refusal alcoholic drinks, but also possible refusal from the use of sleeping pills and sedatives. If delirium tremens is not treated, it may progress and enter the third phase.

Delirium - stage three

Signs of the third stage:

convulsions developing into an epileptic attack;
rapid heartbeat and lack of air;
trembling that spreads throughout the body;
aggression, which is replaced by attacks of sudden apathy;
sleep disturbances, the development of hallucinations that become very vivid and real;
The body's reactions are very sluggish and inhibited.

If left untreated, the third phase may progress to a state of coma. This may lead to violations cerebral circulation, swelling of the membranes of the brain, hemorrhages and even death.

Many patients are interested in the question “How to stop an attack of delirium tremens at home?”, but ideal option is considered to be receiving qualified assistance. With help medicines the attack can be eliminated in a few hours.

Unfortunately, not all patients want to undergo treatment in specialized institutions, or for some reason they need to be at home. If appropriate treatment is not carried out, irreversible consequences may develop.

In order to eliminate an attack of delirium tremens, you can use Popov’s recipe, which includes:

phenobarbital – 3 tablets;
96% ethanol– 20 ml;
distilled water – 100 ml.

All the ingredients of the recipe should be mixed together and drunk at one time. Phenobarbital can be replaced by another sleeping pill.

Delirium tremens: home treatment with traditional methods

Alcoholic delirium has very deep roots, and attempts have been made to treat it accordingly since ancient times. Because the drug treatment had not yet been invented, they used decoctions and tinctures prepared from medicinal plant materials.

Some recipes for these remedies have survived to this day and are especially popular.

Tincture based on the herb yarrow and wormwood. Take the herbs in equal quantities and infuse in vodka for ten days. This tincture allows you to stop an attack of delirium tremens for a while.
To prepare the next tincture you will need lovage root and two bay leaves; you need to infuse it in a liquid containing 40% ethyl alcohol for a week. After time, strain the mixture and you can take 2-3 drops three times a day.
A decoction based on a mixture of herbs: wormwood, yarrow and thyme. All herbs must be taken equal quantities 20 grams each, and pour 200 ml boiled water. After cooling, the decoction is ready for use.
There is a belief that systematic consumption of sour apples can lead to complete cure from attacks of delirium tremens.

What can alcohol delirium lead to?

Frequent attacks of delirium tremens do not pass without a trace, and as a result, the development of pathological conditions internal organs and systems. First of all, the brain suffers, but in addition, the development of such diseases as:

alcoholic cardiomyopathy is observed in ¼ of all patients, and often causes death;
pneumonia develops in 1/3 of all victims;
swelling of the membranes of the brain;
inflammation of the pancreas;
problems with absorption and metabolism of vitamins and minerals;
malfunctions of the liver and kidneys;
Rhabdomyolysis

Ultimately, treatment for delirium delirium may have several outcomes, including: full recovery, partial recovery with persistence of some symptoms of delirium tremens and death of the patient.

Treatment using prescription medications (tranquilizers, sleeping pills) is carried out only in a hospital setting, and under the strict supervision of the attending physician. The doctor will adjust the doses of medications and monitor the patient’s condition.

At the first manifestations of delirium tremens, it is better to seek qualified help, since home therapy can lead to irreversible consequences that even doctors cannot correct.

Delirium tremens (delirium tremens, dromomania, delirium tremens) is the most common acute alcoholic psychosis (70–75% of all alcoholic psychoses). It usually develops in chronic alcoholics with more than 5 years of experience after long, heavy binges during the abstinence period, usually 2–4 days after drinking. Sometimes delirium tremens is preceded by malaise, insomnia, headaches, somatic diseases. At this time, an aversion to alcohol often appears, and patients stop drinking. Psychosis develops rapidly, reaching a peak within just a few hours. This usually happens in the evening or at night.

Symptoms and course

The patient's orientation in space and time is disturbed. Characteristic sign delirium is an influx of abundant, vivid illusions and hallucinations.

Visual hallucinations predominate. Most often, patients see various moving small animals: snakes, rodents, insects, spiders, etc. Patients can see devils teasing and sticking out their tongues at them. Sometimes large animals also appear: bears, bulls, elephants, dogs. Patients can fight with them, scold them, escape from their attack; collect insects from your body, clothes, walls, throw them off, crush them with your feet, etc.

Auditory hallucinations. The patient hears voices coming from everywhere, remarks addressed to the patient, condemning, scolding him and threatening him. The patient talks to these voices, argues with them, makes excuses, threatens in response. Sometimes auditory hallucinations are in the nature of orders that the patient carries out.

Tactile hallucinations are manifested by a realistic sensation of a foreign object in the mouth (thread or hair), the sensation of insects crawling over the body, or their bites.

The listed hallucinations can appear in combinations with each other. In this case, the images are in the nature of plots and scenes on a specific topic, in which the patient acts as a central figure. Hallucinations associated with the profession are not uncommon: a shoemaker wields an imaginary hammer, hammering imaginary nails into the sole, holding the nails in his mouth, etc.

In addition to hallucinations, illusions often occur. Patients perceive their surroundings pervertedly: they see changing fantastic images based on real objects (ornaments, wallpaper designs, etc.).

With delirium tremens, as a rule, there are fragmentary crazy ideas, reflecting hallucinatory experiences. The patient's mood is anxious and depressed. During hallucinations, patients often experience fear and are subject to outbursts of aggression, which makes them dangerous at these moments. But severe melancholy, a state of hopelessness, can also develop, under the influence of which, as well as under the influence of fear, the patient can commit suicide. Occasionally during delirium tremens, euphoria occurs with the flat humor characteristic of chronic alcoholics.

As a rule, during delirium tremens, motor excitation occurs, reflecting the visionary scenes experienced by the patient. The patient attacks imaginary opponents and runs away from them; at the same time, he can jump out of the window of a house or throw himself under a car.

Somatic symptoms:

pronounced trembling as with chills;
dilated pupils while maintaining their reaction to light;
strengthening of tendon reflexes;
increase in body temperature to 37-38.5°;
increased heart rate, increased blood pressure;
redness of the skin, especially the face;
expressed inflammatory phenomena from the gastrointestinal tract, the tongue is coated;
enlarged liver, painful when palpated;
increased levels of leukocytes and bilirubin in the blood, accelerated ESR.

According to severity alcoholic delirium are divided into:

abortive (last several hours, there are no pronounced disturbances of consciousness and agitation, they go away without treatment, criticism of one’s condition remains);
delirium with a predominance of auditory hallucinations;
classic delirium tremens;
fantastic delirium (detachment, darkened consciousness, disorder of self-awareness with depressive or manic affect);
severe forms (professional, murmuring (“mumbling”) delirium; with signs of acute disorders of the functions of the brain, consciousness, neurological and somatic disorders).

Delirium tremens lasts 3–5 days, less often – a week. Intensity indicated clinical symptoms V different time the day fluctuates. Psychosis is especially pronounced at dusk and at night. Throughout the course of the disease, patients sleep very little, their sleep is severely disturbed.
Usually the disease ends as unexpectedly as it began. Within a few hours the symptoms subside. Patients fall asleep for a long time deep sleep and wake up without signs of illness. Only over the next few days is asthenia observed - a consequence of psychosis.

Treatment

Delirium tremens refers to emergency and requires emergency therapeutic measures. Treatment is carried out within the framework of specialized medical care in a psychiatric hospital setting.

The main tactical objectives of treatment are to relieve agitation and insomnia, prevent seizures, relieve intoxication, and combat concomitant pathology and complications.

Neuroleptics and benzodiazepines are used to treat delirium tremens. Treatment is carried out in a ward (department) intensive care. Excitement is relieved with neuroleptics, devoid of pronounced sedative effect, the risk of excessive reduction in blood pressure. The drug of choice among antipsychotics is haloperidol in a dosage of 2–10 mg IM; if the excitement is not relieved, the indicated dose is re-administered every hour. Upon reaching calming effect switch to enteral administration of haloperidol (10–60 mg per day).

Phenothiazines (Chlorpromazine and others) are also used in the treatment of delirium, but they more often cause a decrease in blood pressure and sedative effect. Zuclopenthixol and quetiapine are also used. Benzodiazepines (for example, diazepam, triazolam, nitrazepam) help treat insomnia. Benzodiazepines reduce the likelihood of developing seizures. However, some patients require additional anticonvulsant therapy with hydantoin or barbiturates.

Carbamazepine is effective in relieving agitation and seizures in abortive form delirium tremens. Compared to benzodiazepines, the drug is more successful in suppressing psychosis. But in case of severe delirium it is not used.

For delirium, detoxification and hydration therapy are additionally carried out; appoint loading doses vitamins of group B (especially B1) and C. Intoxication is relieved by hemosorption, intravenous drip infusions of hemodez, glucose, rheopolyglucin. Infusions are often used isotonic solution, unithiol, magnesium sulfate, sodium thiosulfate. Heart activity is supported by corglycone and cordiamine. To prevent cerebral edema, Lasix (1% solution) is administered.

Help at home

We should immediately make a reservation: treating delirium tremens at home is impossible. The consequences of such attempts can be lethal. We can only give a few tips on how to carry out urgent measures before qualified assistance is provided:

put the patient with delirium tremens on the bed and keep him in this position until the doctors arrive;
if necessary, tie him to the bed;
give plenty of fluids to relieve intoxication;
A cold shower wouldn't hurt.

Conclusion

“Are you still drinking? Then I’m coming to you!” – the frightening-looking squirrel decisively declared, pointing at you with its furry, clawed paw.
Delirium tremens, which is popularly associated with this harmless rodent, has long become a reason for jokes and funny stories. However, we must not forget how much dangerous consequences conceals this disease, the mortality rate of which is 10–25%. That's why preventive measures against this alcoholic psychosis are of no small importance. Prevention of delirium tremens comes down to prevention and treatment chronic alcoholism, to restriction, or better yet, to complete refusal from drinking strong drinks.