What is delirium tremens (DTs) primarily caused by?

Delirium tremens (DTs) is primarily caused by alcohol withdrawal, particularly in individuals who have developed a dependence on alcohol. When an individual who has been consuming large amounts of alcohol suddenly reduces or stops their intake, the body, which has adapted to the presence of alcohol, experiences a severe rebound effect. This can lead to significant disruptions in neurotransmitter systems, particularly those involving gamma-aminobutyric acid (GABA) and glutamate.

As a result, symptoms of DTs can manifest, including severe agitation, confusion, hallucinations, and autonomic instability, such as increased heart rate and blood pressure. The onset of delirium tremens typically occurs 48 to 72 hours after the last drink and can pose serious risks, including seizures and even death if not properly treated.

Factors contributing to the severity of withdrawal symptoms, including DTs, can include the amount and duration of alcohol use, previous history of withdrawal delirium, and the presence of comorbid medical or psychiatric conditions. Understanding this condition is crucial for managing and treating patients in withdrawal and ensuring their safety and health during recovery.