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Acute Alcohol Withdrawal Syndrome

Acute Alcohol Withdrawal Syndrome

What is alcohol withdrawal? — Alcohol withdrawal is a condition that happens when a person who often drinks large amounts of alcohol suddenly stops drinking alcohol. People with alcohol withdrawal often have a headache, a stomach ache, and trouble sleeping. But sometimes, the symptoms are much more serious and even life threatening.
What are the symptoms of alcohol withdrawal? — Mild symptoms include:
Trouble sleeping
Feeling anxious
Having an upset stomach and not wanting to eat
Feeling like your heart is beating fast, beating hard, or seems to skip a beat – These heartbeat changes are called "palpitations."
These symptoms often start within 6 hours after a person stops drinking. They might go away within 1 or 2 days. But some people also get more serious symptoms, including:
Seizures – These are waves of abnormal electrical activity in the brain. They can make a person pass out, or move or behave strangely. With alcohol withdrawal, seizures usually happen within 12 to 48 hours after the person stops drinking.
Hallucinations – Hallucinations are when you hear, see, feel, smell, or taste things that aren't there. With alcohol withdrawal, the most common type is seeing things that aren't there. This symptom tends to happen within 12 to 24 hours after the person stops drinking and stop within 1 or 2 days.
Delirium tremens or DT – This is the most serious form of alcohol withdrawal. Symptoms include:
•Feeling confused about where you are or who you are
•Feeling very upset and anxious
•Uncontrolled shaking
•A fast heartbeat
•High blood pressure
The symptoms start 2 to 4 days after a person stops drinking and can last up to 5 days.
Should I see a doctor or nurse? — See your doctor or nurse right away, even if you have mild symptoms of alcohol withdrawal. The symptoms can get more serious and possibly fatal if you are not treated.
Is there a test for alcohol withdrawal? — Your doctor or nurse should be able to tell if you have it by learning about your symptoms and doing an exam. But they might do tests to check for other problems. These tests include:
Blood tests
Urine tests
A CT scan of your head – A CT scan is an imaging test that can create pictures of the brain.
A lumbar puncture (sometimes called a "spinal tap") – During this procedure, your doctor puts a thin needle into your lower back and takes out a small amount of spinal fluid. Spinal fluid is the fluid that surrounds the brain and spinal cord. Your doctor will send the spinal fluid to a lab for tests.
How is alcohol withdrawal treated? — The treatment depends on your symptoms. If you have mild symptoms, your doctor might prescribe medicines to take at home. But to do this, you need to meet these conditions:
Have a reliable relative or friend who can stay with you for 3 to 5 days to make sure your symptoms are not getting worse
Be able to go in for a medical visit every day
Not be pregnant or have any physical or mental health problems
Not have other substance abuse problems, such as taking illegal drugs
Have never had serious alcohol withdrawal symptoms in the past
If you do not meet these conditions or if you have serious symptoms, you will be treated in the hospital. You might get medicines through a thin tube that goes into your vein, called an "IV." All people treated for alcohol withdrawal should also take multivitamins (as pills or through an IV).
Your doctor or nurse will also refer you to a program to treat people with alcohol problems. In these programs, people can:
See a counselor (such as a psychologist, social worker, or psychiatrist)
Take medicines
Take part in a social support group like AA (Alcoholics Anonymous)
All of these treatments can help, and you can do more than one at the same time.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83392 Version 6.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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