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Alcohol Withdrawal

Alcohol Withdrawal symptoms appear when a person accustomed to frequent high consumption of alcohol suddenly stops consuming alcohol. Such alcohol withdrawal symptoms do not occur in occasional drinkers. Since alcohol has a sedating effect on the brain, the brain of a heavy drinker adjusts itself to high levels of alcohol by producing larger amounts of serotonin. When there is sudden withdrawal of alcohol, the brain has to cope with a dramatic change in chemistry.


The body experiences alcohol withdrawal symptoms such as anxiety and irritability. Alcohol withdrawal symptoms include depression, difficulty in concentration and clear thinking. There are emotional changes that also occur. A person experiencing alcohol withdrawal may suffer headache, nausea and vomiting. There is loss of appetite and clammy skin. Often there is involuntary tremors in the hands and other abnormal movements. Alcohol withdrawal can result in a delirious state of hallucinations.


The patient may suffer damage to other organs due to excessive consumption of alcohol. There may be nutritional deficiencies. Treatment for alcohol withdrawal includes screening and providing extensive social support. Medicines such as benzodiazepines are prescribed to control anxiety and confusion associated with alcohol withdrawal. Adequate nutrition and sufficient rest are advised. Dietary changes such as reduced sugar intake and avoidance of caffeine are part of the treatment for alcohol withdrawal.

Delirium Tremens

Delirium Tremens or DT is a serious condition of alcohol withdrawal syndrome. DT leads to sudden and severe mental and nervous system changes.


Causes of Delirium Tremens

When a person suddenly stops drinking alcohol after a period of heavy consumption, and does not eat enough food, delirium tremens occurs. This means, a person consuming 4-5 pints of wine or 7-8 pints of beer of a pint of hard alcohol every day for several months. This could happen to people with more than a decade of drinking alcohol.

One important reason is that in long term drinkers, alcohol interferes with body's ability to regulate a neurotransmitter called GABA. In chronic alcohol abuse, the body mistakes alcohol for GABA and reacts to this by reducing its production of the neurotransmitter. As alcohol levels falls too low, it means there is not enough GABA for proper functioning. This can also occur due to infection, injury and illness in people with a history of heavy alcohol use and abuse.


Signs and symptoms of Delirium Tremens

Symptoms normally occur within 72 hours of the last drink, but they can also occur up to 10 days after the last drink. Common symptoms include:


  • Body tremors
  • Functional changes
  • Agitation
  • Anger and irritability
  • Confusion and loss of focus
  • Reduced attention span
  • Deep sleep that lasts for a day or longer
  • Excitement and fear
  • Hallucination
  • Hyperactivity
  • Quick mood reversals
  • Restlessness
  • Sensitivity to light, sound and touch
  • Sleeplessness and fatigue.

There could be seizures, most commonly in the first 12-48 hours after the last drink. As DT can temporarily reduce the amount of blood flow to the brain, symptoms as confusion, disorientation, stupor and loss of consciousness and hallucinations occur. There are other medical complications that can arise due to alcohol abuse. These include:


  • Alcoholic liver disease
  • Cardiomyopathy
  • Neuropathy
  • Blood clotting disorders
  • Wernicke Korsakoff's syndrome, a brain disorder due to thiamine deficiency
  • Injury from fall during seizures
  • Irregular heartbeat which can be life threatening
  • Delirium and injury to self/others in a state of confusion

The body goes through change due to withdrawal of alcohol when a person suddenly stops drinking after prolonged use. Alcohol has a slowing and sedating effect on the brain and the brain of a long term drinker is conditionally exposed to the depressant effect of alcohol. The brain starts producing naturally stimulating chemicals to compensate for the effect of alcohol. Hence, if the alcohol is withdrawn suddenly, the brain is lost. This dangerous condition of delirium tremens occurs in almost 1 out of every 20 persons. In this condition the brain is unable to read the chemistry after alcohol is stopped and therefore creates a temporary confusion leading to dangerous changes in the way the brain regulates body circulation and breathing. This creates risk of heart attack, stroke and death.


Diagnosis of DT

Blood tests can be done to assess blood magnesium and blood phosphate levels. Comprehensive metabolic panel and toxicology tests are also conducted. A stay in hospital in required for treatment. Regular checks of blood chemistry levels, such as electrolytes, body fluids level and vital signs such as temperature, pulse, breathing rate and blood pressure are monitored. Medications such as anticonvulsants, central nervous system depressants and sedatives are administered for symptoms such as seizures and irregular heartbeat. Sometimes the patient is put in a state of sedation for a week until withdrawal is complete. Benzodiazepine medications are given to treat seizures, anxiety and tremors. Only after the patient recovers from immediate symptoms is long term preventive treatment given. The doctor allows a ‘drying out' period in which no alcohol is consumed.


Foetal Alcohol Syndrome

The effects of alcohol consumption by a pregnant woman on her fetus are alarming. Foetal alcohol syndrome (FAS)refers to the distressing features observed in babies who have been exposed to alcohol before birth. In fact in some cases, the baby stands a risk of dying before birth. Alcohol crosses the placental barrier into the baby's bloodstream. It can reduce the amount of oxygen available to the growing fetus and lead to nutritional deficiency too. There may be retarded growth of brain cells. When a child suffers lesser symptoms due to maternal alcohol consumption, it is referred to as FAE - Foetal Alcohol Effect.


One of the most common features of a child suffering from Fetal Alcohol syndrome is low birth weight. The infant may have small eyes and flattened face. The head circumference is smaller than average. There might be heart defects. Foetal alcohol syndrome is not always diagnosed at birth. It may be diagnosed when there is a learning or growth problem. Babies suffering from FAS tend to have low IQ and learning difficulties. The child is at increased risk for behaviour and mental health issues. There are cases of cleft palate deformity and joint abnormalities in children born to mothers who consume large quantities of alcohol during their pregnancy. It is advisable for pregnant women to refrain from alcohol during their pregnancy to avoid FAS and FAE among their offsprings. It can lead to a lifetime of impaired mental and physical growth.

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Collection of Pages - Last revised Date: June 24, 2019