31st January 2024

Differential diagnoses

Alcohol hallucinosis (sometimes referred to as ‘alcohol-induced psychotic disorder’) can present very similarly to delirium tremens, but they are not identical conditions. ICD-10 describes alcohol hallucinosis as characterised by hallucinations, which develop within two weeks of heavy alcohol intake and last for at least 2 or more days. Unlike delirium tremens, impaired cognition should not be a major feature of the condition.

There is little information available about this condition; however, it does seem to be recognised as distinct from delirium tremens and schizophrenia, and dopamine and serotonin receptor involvement have been suggested as likely aetiological factors to consider. Proposed treatments currently also include benzodiazepines, atypical antipsychotics, and abstinence from alcohol (if safely achievable).

Although delirium tremens is a clinical condition, other organic conditions which have similar symptom profiles and should be considered where appropriate, e.g., space-occupying lesions.