Table 1.

Features of acute alcohol withdrawal.

TypeOnsetaFeaturesOffsetFittingOther features
Minor symptom complex (majority)6–8 hGeneralised hyperactivity, anxiety, tremor, sweating, nausea, retching, tachycardia, systemic hypertension, mild pyrexia
(Peak 10–30 h)
40–50 hYes: first 12–48 hAuditory/visual hallucinations: may last for 5–6 days
Delirium tremens (<5%)48–72 hCoarse tremor, agitation, fever, tachycardia, profound confusion, delusions and hallucinationsFatal if not effectively treatedNo: may herald the syndrome but is not part of itHyperpyrexia, ketoacidosis and profound circulatory collapse if not effectively curtailed
afollowing abrupt cessation or a substantial reduction in alcohol intake.