Investigation of pre-delirium and delirium in patients with alcohol withdraw

Abstract

Introduction: Alcohol withdraw syndrome (AWS) and delirium tremens (DTs) are part of the clinical picture of alcohol dependence (AD). The mechanisms by which these conditions develop are not entirely understood, but there are data suggesting that several factors are largely responsible for the emergence of the AWS and DTs. According to some authors, with the prolongation of the AD and increasing tolerance, the AWS aggravates, somatic and neurovegetative manifestations worsen. Russian authors accept that the degree of clinical manifestations depends on the individual characteristics of the response to ethanol. Materials and methods: The present work is a systematic study of 28 alcohol-dependent patients that developed clinical signs and symptoms of pre-delirium and delirium during alcohol detoxification treatment. Results: The relationship between sex, age, type and duration for abuse, type of alcoholic beverage, and the clinical picture has been analyzed and discussed as well as the criteria for their diagnosis and follow-up. Conclusion: Our analysis of the development and the manifestations of pre-delirium and DTs, during detoxification of AD patients, underlines the protracted course of the illness and the need for multidisciplinary intensive care. Dynamic monitoring of the patients and timely correction of the therapeutic program guarantee the success of the detoxification.

Keywords:

• toxicology
• alcohol dependence
• withdraw
• pre-delirium
• delirium tremens
• psychiatry
• addiction

Public Interest Statement

Alcohol withdraw is a serious clinical syndrome and also a part of the clinical picture of Alcohol use disorder. As alcohol use is widely spread and socially acceptable in most countries around the world, it is important for health care professionals to recognize its consequences and be able to provide adequate management of such patients based on reliable assessments of its severity. In our article, the relationship between sex, age, type and duration of use, type of alcoholic beverage, and the clinical picture has been analyzed and discussed.

Competing Interests

The authors have no competing interests.

Additional information

Funding

Funding. The authors received no direct funding for this research.

Notes on contributors

Krasimir Kostadinov

The Military Medical Academy (MMA)—Sofia is a large complex for medical treatment, as well as education, located in Sofia, Bulgaria. It has several branches and smaller clinics in other cities in the country. The current investigation was carried out by the Department of Emergency Toxicology of The MMA—Sofia, led by Lyudmila Neykova-Vasileva and in close collaboration with Tony Donchev and Krasimir Kostadinov of the Department of Psychiatry, MMA-Sofia. Our team, as members of the both clinics, is dedicated to providing quality care for patients with substance abuse disorders both in acute and chronic settings.