Non-alcoholic (somatogenic) delirium

The first signs of delirium tremens

The following symptoms may indicate that delirium delirium has begun:

Lack of craving for alcohol. An alcoholic suddenly loses his craving for alcohol and may even experience disgust;
Sudden mood changes. A sign of approaching delirium may be a change from a joyful state to unexpected depression, fear, or melancholy. The person suddenly becomes agitated and cannot sit in one place for a long time;
Insomnia, restless sleep, including nightmares. After waking up, the patient often experiences terrible visual images or hears non-existent sounds;
Trembling of limbs.

Alcoholic delirium is very dangerous for the health and even the life of the patient and the people around him. In such a state, a person, trying to get rid of obsessive hallucinations or “obeying” someone’s orders, can commit suicide, for example, jumping out of a window, hanging himself, or, on the contrary, rushing to help, as it seems to him, the victim, but in fact only causing harm to him.

During an attack of delirium tremens, a person loses orientation in space and time - he does not know what day it is, where he is, where he should go. Although, it is worth noting that he can provide his name and personal information very accurately.

Between visions, so-called lucid periods occur, when the visions go away and the patient can even talk about them.

The development of the disease occurs in stages and can occur in different ways. Depending on the type of pathology, the treatment regimen and types of drugs for it depend. The following types of delirium are distinguished:

Classical. Symptoms appear gradually; several successive stages of pathology development occur.
Lucid. This type of delirium is characterized by an acute onset of the disease, there are no hallucinations, a delusional state, anxiety, tremors, coordination disorders, and fear are more pronounced.
Abortive delirium. This form is characterized by fragmentary hallucinations, fragmentary, insufficiently formed delusional ideas. The person has severe anxiety. This type can develop into another form of psychosis, and sometimes recovery is noted.
Professional delirium. The development of psychosis begins as in a typical squirrel. Further, delusions and hallucinations are reduced, and repetitive movements that are associated with a person’s work, undressing, dressing, etc. begin to prevail in the clinical picture.
Delirious delirium. This is the next stage, which begins from the professional form, but can sometimes develop from other types of disease. Signs include severe, pronounced clouding of consciousness, somatovegetative disorders, and characteristic movement disorders.
Atypical delirium. Occurs in patients who have previously suffered from other forms of delirium tremens, alcoholic psychosis. This type includes symptoms similar to schizophrenia.

Common symptoms of delirium

As a rule, the onset of this condition comes in an acute form. However, when delirium occurs, some symptoms may signal its onset. They are called prodromal. These include:

unjustified anxiety;
anxiety;
feeling of fear;
increased sensitivity to light or sound;
the patient's consciousness is confused, disorientated.

When these symptoms occur, we can say that a state of delirium has set in. A person in this state may confuse dreams and reality due to disruption of the cyclical period of sleep and wakefulness. Also, patients are indistinguishable from dreams and true hallucinations. Attention decreases; irrelevant stimuli can switch attention quite easily. In addition, other thought processes slow down significantly. A person may not remember what happened to him during the period of delirium, or perceive it as a dream due to remembering only certain parts.

Alcoholic delirium: code according to ICD 10

According to the International Classification of Diseases (ICD), the code for alcoholic delirium is 10. This disease is typical for people with stages II and III of alcoholism, that is, abusing alcohol for 5–7 years. This condition is observed 1–3 days after the binge stops or on the 4th dash of the sixth day.

There are known cases of people experiencing delirium tremens as a result of poisoning with surrogate alcohol, even in those who did not suffer from addiction. The problem has become widespread also because the market is oversaturated with all kinds of counterfeits.

Also, if there is a traumatic brain injury or central nervous system disease, a person is more likely to develop delirium. For survivors of alcoholic psychosis, signs of delirium tremens can usually occur with even minor alcohol intake.

As part of the disease and the possibility of a mental disorder, sleep disturbances and anxiety are included. The duration of the acute condition, which is accompanied by confusion of mind, usually ranges from 3 to 5 days. In this case, the situation can develop in different ways.

A person deprived of normal sleep can simply fall into madness, showing inadequacy and danger to everything around him. Symptoms do not differ much across all stages of delirium delirium.

Clinic

This section is not completed.
You will help the project by correcting and expanding it.

: Incorrect or missing image

This section is missing references to information sources.
Information must be verifiable, otherwise it may be questioned and deleted. You may edit this article to include links to authoritative sources. This mark is set May 12, 2011

K: Wikipedia: Articles without sources (type: not specified)
Delirium can occur at the highest stage of an infectious disease. Delirium caused by alcohol abuse is called “delirium tremens.” The duration of delirium can vary from a few hours to several weeks. Although memory of experiences during delirium is generally preserved, partial amnesia is often observed after delirium.

With delirium, the following somatovegetative disorders are noted:

sweating
fluctuations in body temperature
blood pressure fluctuations
muscle weakness
tachycardia
large-scale tremor
unsteadiness of gait

Causes

Alcoholism becomes the main and main factor in the development of pathology. Additional factors include long-term consumption, low-quality alcoholic beverages (technical liquids, alcohol surrogates, pharmacological preparations with alcohol), severe pathologies of internal organs. The following factors can also lead to typical delirium:

Traumatic brain injuries have some significance, as does a history of brain disease.
According to doctors, a decisive role is played by chronic intoxication of the body and metabolic disorders in the brain.
The likelihood of delirium tremens increases due to severe physical and mental stress, for example, if the patient is injured while intoxicated and ends up in the hospital. Alcohol stops entering the body, withdrawal syndrome develops against the background of a change of environment, discomfort and physical pain, and worries about injury.
A situation similar to the situation described above develops when drunken patients are admitted to a hospital department (cardiology, gastroenterology).
At home, delirium develops, as a rule, after a sharp exit from binge drinking against the background of exacerbation of somatic disorders.

Alcoholic delirium is what is commonly called delirium tremens, caused by an abrupt cessation of binge drinking in alcoholics, and also, extremely rarely, by excessive consumption of the “green snake”. A psychiatrist can make this diagnosis only in consultation with a narcologist. The nature of the described mental disorder is always exogenous, that is, it depends on external factors. The causes of psychosis are divided into three groups:

Delirium in diseases of the central nervous system - meningitis, epilepsy.
For somatic systemic diseases - renal, pulmonary, heart failure.
With long-term constant intoxication of the body - alcohol, drugs, medications.

Signs of alcoholic delirium begin long before the actual attack, sometimes several days. The patient abruptly stops drinking alcohol, saying that he is no longer interested in alcohol; his mood changes, then trembling in his limbs and hallucinations occur. Then, closer to midnight, alcoholic delirium sets in directly with immediate manifestation and dynamics.

Delirium in alcoholism is characterized by the following symptoms:

General aggressive state.
Hallucinations.
Memory loss (partial: the patient remembers his personal data - birthday, last name - but forgets the simplest things about loved ones, even the names of relatives, may forget his place of residence).
Tremor (shaking in hands, knees).
Incoherent speech, jerky sentences, delirium.
Disorientation, loss of sense of time and space.
Sweating, fever, pallor, chills, blood pressure.

Causes of impaired consciousness

There can be many reasons for the disease: taking chemical substances (alcohol, anesthetics, drugs); drug withdrawal, hypoxia, sleep deprivation, somatic diseases, renal failure, central nervous system diseases, neoplasms, hyperthyroidism, liver failure, hyperglycemia, as well as the postoperative period and various infections.

Three main factors have been established that predispose to the development of insanity: old age, brain damage, and addiction to drugs and alcohol. There are medical observations that stable individuals are less susceptible to delirium.

From a physiological point of view, the state of delirium is a reflection of acute depression of brain functions caused by extensive metabolic disorders that cover all structures of the central nervous system. This disorder of consciousness is an indicator of a disruption in the normal functioning of the brain and a breakdown in the mental balance of the body due to exhaustion and exhaustion of adaptive (compensatory) mechanisms.

All causes of delirium can be divided into three categories:

pronounced defects of the central nervous system;
severe diseases of internal organs;
toxic agents.

The state of delirium can be caused by a variety of somatic diseases and diseases of the central nervous system. Delirium often develops during attacks of a chronic neurological disease - epilepsy. Impaired consciousness is a characteristic symptom of inflammation of the membranes of the brain and spinal cord. Severe disruptions in mental activity are observed with inflammation of the brain.

The cause of delirium may be an insufficient supply of oxygen to the brain tissue. In some situations, delirium is triggered by sleep deprivation. Delirium can be a companion to diseases that are accompanied by an increase in body temperature, for example: pneumonia.

This type of impairment of consciousness may be the result of a negative effect on the brain of toxic agents. Any neurotoxins coming from the external environment can trigger delirium. Many drugs, especially psychostimulants, have neurotoxicity. Intoxication of the body with breakdown products of ethyl alcohol leads to delirium delirium, popularly called “delirium tremens”.

Symptom relief

The main symptom of delirium tremens is hallucinations. An attack of delirium tremens in most cases occurs at night and is characterized by a progressive nature. Hallucinations are dominated by images of small animals, insects and amphibians, for example, rats and mice, snakes and spiders. Most often, those whom a person in a normal state fears, and in the old days, believing alcoholics imagined devils.

We suggest you read: Fighting alcoholism at home

There may also be visions of ropes, nets and cobwebs from which a person cannot get out, or “scenes from horror films.”

Auditory hallucinations are manifested by the fact that the patient hears screams of horror, animal cries, threats, and name-calling addressed to himself.

Cases of painful, often unfounded, jealousy are not uncommon during delirium tremens.

All symptoms of alcoholic delirium are noticeable to others, as they are reflected by the alcoholic’s facial expressions. Grimaces of horror, confusion and fear appear on his face. He tries to hide, pushes someone away from him, throws off imaginary reptiles. With tactile hallucinations, a person feels these insects crawling or biting him, beating him or cutting him, etc.

Alcoholic psychosis is characterized by the sensation of a foreign body in the mouth - they try in every possible way to pull it out with their hands or spit it out.

The speech of an alcoholic during an attack is slurred and intermittent - he talks to images of his visions, shouts out individual words or remarks.

Somatic symptoms of alcoholic delirium include:

Tremor;
Hyperemia;
Increased body temperature to 39 degrees;
High arterial hypertension (can reach 160-180/mmHg);
Increased sweating;
Strengthening tendon reflexes.

In this case, the work of all or almost all internal organs is disrupted.

Typical alcoholic psychosis lasts from 3 to 5 days. The first positive sign of recovery from it is an improvement in the quality of sleep.

Alcoholic delirium most often develops 2-3 days after stopping alcohol intake. A harbinger of the main symptoms of alcoholic delirium can be sleep disturbance. Restless sleep, accompanied by nightmares, does not lead to rest. Symptoms such as headache, nausea, vomiting, speech impairment, etc. may also appear. However, they are not specific and most often accompany any withdrawal syndrome.

-psychotic;

-vegetative;

-organic brain damage.

Early symptoms of alcoholic delirium are anxiety, a feeling of inexplicable threat, and fear. General somatic symptoms appear: increased sweating, trembling hands, rapid heartbeat, high blood pressure. Sleep disturbance gradually turns into insomnia. The patient is haunted by vivid auditory and visual hallucinations.

During alcoholic delirium, the patient may “hear” voices ordering him something, scolding him, calling him names, teasing him. The person's behavior becomes inappropriate. He is completely captivated by hallucinations: he “talks” with someone, screams, tries to run away, “catches” “insects” on himself and his clothes, etc. Sometimes boastful behavior appears: in a state of excitement, the patient talks about his “exploits.”

The state of excitement can be replaced by periods of imaginary well-being, during which behavior becomes more calm and adequate. However, after a short period of time, the symptoms of delirium tremens resume.

Somatic symptoms in a fully developed clinical picture of delirium tremens include: hyperthermia (up to 38-39 °C), high arterial hypertension (160-180/110 mmHg), tremor, increased tendon reflexes, increased sweating. The work of all internal organs is disrupted.

Typical alcoholic delirium lasts 3-5 days. The first positive symptom of recovery from delirium tremens is improved sleep.

Signs of the disease can be of two types, that is, mental and somatic. Their manifestation occurs in a complex, so the doctor makes an accurate diagnosis, identifying the original cause. The main symptoms of alcoholic delirium are as follows:

From a mental point of view:
obsessive, delusional ideas and anxiety;
panicky feeling of fear;
various hallucinations;
increased degree of arousal;
temporal-spatial disorientation.
From a somatic point of view:
increased heart rate and blood pressure. Body temperature up to 39–40 °C;
headache, nausea (including vomiting), shortness of breath;
periodic seizures;
flushed face.

Delirium tremens is easy to distinguish by hallucinations. It’s not for nothing that many people say about a person that he “got drunk as hell,” and this is by no means a joke. Alcoholics can actually see animals and insects crawling on their bodies or characters from fairy tales.

The imagination of an alcoholic can be unpredictable, because, in addition to visual hallucinations, he imagines touching. In the process of fighting imaginary devils, the patient seeks to injure himself, but is not aggressive towards strangers.

Another common disorder is a disruption in water-salt homeostasis, which occurs due to changes in metabolism as a whole. Long-term heavy drinking contributes to a significant increase in the concentration of ethanol in the blood, so the body has to mobilize its own strength. As a result, the metabolic process in the body occurs with reduced intensity. Interruptions in the functioning of internal organs begin, and death is possible.

There are two main types of signs of the development of the disease - somatic and mental. They usually appear together, so doctors are almost 100% guaranteed to make the correct diagnosis. The most striking sign is hallucinations; in reality, a person observes various insects, animals or fantastic creatures.

Physiological

This is one of the types of symptoms that are inherent in alcoholic psychosis. This group includes signs of pathology that are of a direct physiological nature. The following key symptoms of this type are identified:

sweating;
hand tremors;
facial redness;
limbs are cold;
Heart rate over 100 beats;
dyspnea;
Blood pressure rises to 180/100;
vomit;
body temperature rises to 40 degrees;
convulsions;
headache.

This group of symptoms is associated with delusional disorders and serious brain damage. They appear simultaneously with physiological symptoms and form a complete picture of delirium. This group includes the following manifestations:

rave;
insomnia, nightmares and other sleep disorders;
tactile, auditory, visual hallucinations;
anxiety;
panicky feeling of fear;
disorientation in space and time;
excessive excitement.

As soon as clinical manifestations of alcoholic hallucinosis are noticed, an ambulance should be immediately called to hospitalize the patient. For treatment, a person is sent to a drug treatment or psychiatric clinic, where he can receive the necessary observation and drug treatment. Before the ambulance arrives, it is necessary to place the patient with characteristic mental symptoms in bed and maintain this position for as long as possible. When treating alcoholic delirium, a person should not be left alone for a second.

Excerpt describing Delirium

As he fell asleep, he kept thinking about the same thing he had been thinking about all the time - about life and death. And more about death. He felt closer to her. "Love? What is love? - he thought. – Love interferes with death. Love is life. Everything, everything that I understand, I understand only because I love. Everything is, everything exists only because I love. Everything is connected by one thing. Love is God, and to die means for me, a particle of love, to return to the common and eternal source.” These thoughts seemed comforting to him. But these were just thoughts. Something was missing in them, something was one-sided, personal, mental - it was not obvious. And there was the same anxiety and uncertainty. He fell asleep. He saw in a dream that he was lying in the same room in which he was actually lying, but that he was not wounded, but healthy. Many different faces, insignificant, indifferent, appear before Prince Andrei. He talks to them, argues about something unnecessary. They are getting ready to go somewhere. Prince Andrey vaguely remembers that all this is insignificant and that he has other, more important concerns, but continues to speak, surprising them, some empty, witty words. Little by little, imperceptibly, all these faces begin to disappear, and everything is replaced by one question about the closed door. He gets up and goes to the door to slide the bolt and lock it. Everything depends on whether he has time or not time to lock her. He walks, he hurries, his legs don’t move, and he knows that he won’t have time to lock the door, but still he painfully strains all his strength. And a painful fear seizes him. And this fear is the fear of death: it stands behind the door. But at the same time, as he powerlessly and awkwardly crawls towards the door, something terrible, on the other hand, is already, pressing, breaking into it. Something inhuman - death - is breaking at the door, and we must hold it back. He grabs the door, strains his last efforts - it is no longer possible to lock it - at least to hold it; but his strength is weak, clumsy, and, pressed by the terrible, the door opens and closes again. Once again it pressed from there. The last, supernatural efforts were in vain, and both halves opened silently. It has entered, and it is death. And Prince Andrei died. But at the same moment as he died, Prince Andrei remembered that he was sleeping, and at the same moment as he died, he, making an effort on himself, woke up. “Yes, it was death. I died - I woke up. Yes, death is awakening! - his soul suddenly brightened, and the veil that had hitherto hidden the unknown was lifted before his spiritual gaze. He felt a kind of liberation of the strength previously bound in him and that strange lightness that has not left him since then. When he woke up in a cold sweat and stirred on the sofa, Natasha came up to him and asked what was wrong with him. He did not answer her and, not understanding her, looked at her with a strange look. This was what happened to him two days before the arrival of Princess Marya. From that very day, as the doctor said, the debilitating fever took on a bad character, but Natasha was not interested in what the doctor said: she saw these terrible, more undoubted moral signs for her. From this day on, for Prince Andrei, along with awakening from sleep, awakening from life began. And in relation to the duration of life, it did not seem to him slower than awakening from sleep in relation to the duration of the dream. There was nothing scary or abrupt in this relatively slow awakening. His last days and hours passed as usual and simply. And Princess Marya and Natasha, who did not leave his side, felt it. They did not cry, did not shudder, and lately, feeling this themselves, they no longer walked after him (he was no longer there, he left them), but after the closest memory of him - his body. The feelings of both were so strong that the external, terrible side of death did not affect them, and they did not find it necessary to indulge their grief. They did not cry either in front of him or without him, but they never talked about him among themselves. They felt that they could not put into words what they understood. They both saw him sink deeper and deeper, slowly and calmly, away from them somewhere, and they both knew that this was how it should be and that it was good. He was confessed and given communion; everyone came to say goodbye to him. When their son was brought to him, he put his lips to him and turned away, not because he felt hard or sorry (Princess Marya and Natasha understood this), but only because he believed that this was all that was required of him; but when they told him to bless him, he did what was required and looked around, as if asking if anything else needed to be done. When the last convulsions of the body, abandoned by the spirit, took place, Princess Marya and Natasha were here. – Is it over?! - said Princess Marya, after his body had been lying motionless and cold in front of them for several minutes. Natasha came up, looked into the dead eyes and hurried to close them. She closed them and did not kiss them, but kissed what was her closest memory of him. “Where did he go? Where is he now?..” When the dressed, washed body lay in a coffin on the table, everyone came up to him to say goodbye, and everyone cried. Nikolushka cried from the painful bewilderment that tore his heart. The Countess and Sonya cried out of pity for Natasha and the fact that he was no more. The old count cried that soon, he felt, he would have to take the same terrible step. Natasha and Princess Marya were also crying now, but they were not crying from their personal grief; they wept from the reverent emotion that gripped their souls before the consciousness of the simple and solemn mystery of death that had taken place before them. The totality of causes of phenomena is inaccessible to the human mind. But the need to find reasons is embedded in the human soul. And the human mind, without delving into the innumerability and complexity of the conditions of phenomena, each of which separately can be represented as a cause, grabs the first, most understandable convergence and says: this is the cause. In historical events (where the object of observation is the actions of people), the most primitive convergence seems to be the will of the gods, then the will of those people who stand in the most prominent historical place - historical heroes. But one has only to delve into the essence of each historical event, that is, into the activities of the entire mass of people who participated in the event, to be convinced that the will of the historical hero not only does not guide the actions of the masses, but is itself constantly guided. It would seem that it is all the same to understand the significance of the historical event one way or another. But between the man who says that the peoples of the West went to the East because Napoleon wanted it, and the man who says that it happened because it had to happen, there is the same difference that existed between the people who argued that the earth stands firmly and the planets move around it, and those who said that they do not know what the earth rests on, but they know that there are laws governing the movement of it and other planets. There are no and cannot be reasons for a historical event, except for the only cause of all reasons. But there are laws that govern events, partly unknown, partly groped by us. The discovery of these laws is possible only when we completely renounce the search for causes in the will of one person, just as the discovery of the laws of planetary motion became possible only when people renounced the idea of \u200b\u200bthe affirmation of the earth.

Stages of development of delirium

Getting out of painful madness on your own is quite problematic, especially if it has reached a late stage. When describing alcoholic delirium, the development and types of the disease, doctors distinguish the corresponding stages:

First:
normal state of consciousness and personality as a whole;
return to normal without medical assistance.
Second: delirium accomplished
inability to study independently;
transition to stage III if no therapy was performed.
Third: threat to life
slurred speech;
decreased response to external stimuli, blood pressure and pulse;
the person is no longer aware of himself.

1. Threatening delirium.

Common symptoms of alcohol withdrawal are common. The patient may have all the symptoms described earlier, but the severity is insignificant. In a deployed clinic, disorientation in time and space may appear, but awareness of one’s own personality remains. Body temperature does not exceed subfebrile levels. This stage is reversible and can end arbitrarily.

2. Complete delirium.

We suggest you familiarize yourself with: Vitamins and alcohol. How vitamins can help a drinker

All symptoms are pronounced. Auditory, visual and tactile hallucinations increase. Delusional experiences arise, often of an unpleasant nature. The general somatic condition worsens: shortness of breath appears up to 22-24 breaths per minute, blood pressure (blood pressure) and pulse increase. At this stage, spontaneous resolution of alcoholic delirium is impossible. Without timely assistance, this stage quickly progresses to stage 3.

3. Life-threatening delirium.

All mental symptoms persist along with obvious aggravation of somatic ones. Lethargy appears, speech is slurred, quiet (mumbling), and the reaction to external stimuli decreases. Blood pressure drops sharply, pulse filling weakens, shortness of breath becomes more frequent. Depression of consciousness gradually increases to the point of coma. At this stage, irreversible changes in internal organs and systems can occur, decompensation and, possibly, death occur.

In the later stages of the disease, it is practically impossible to recover from alcoholic psychosis on your own; this condition requires medical attention. There are several stages of the disease that have specific characteristics. The treatment regimen is prescribed taking into account the patient’s condition, so this is an important diagnostic point. The main stages of the development of alcoholic psychosis (delirium) are described below.

Initial

At the first stage, characteristic disturbances in a person’s emotional state are noted. It changes quickly, worry and anxiety are immediately replaced by high spirits, euphoria, then despondency and depression may set in. The patient’s facial expressions and speech remain alive, so the person simply looks worried and nervous. This stage is characterized by the following manifestations:

Any irritants cause an acute reaction: smells, sound, flashes of light.
The patient will talk about vivid memories and images that pop up in his mind.
Fragmentary visual and auditory hallucinations are noted.
At night, a person feels severe anxiety, often wakes up, and has shallow sleep.

This is the stage of complete delirium, when all the symptoms of the disease become more pronounced. The following signs of alcoholic psychosis are noted:

Full-fledged visual hallucinations, auditory and tactile hallucinations are added, in some cases even thermal, olfactory and gustatory.
It seems to a person that they are trying to kill him, that someone is chasing him.
Visual delirium manifests itself in the form of spiders, midges, cobwebs flying around the room, and sometimes images of deceased loved ones appear.
A person feels rats, snakes, small insects crawling on the skin - these are tactile hallucinations.
The above symptom leads to an increase in body temperature, heart rate, and blood pressure.
If the patient has concomitant pathologies, for example, depression, severe trauma, or previous delirium, then the second stage quickly progresses to the third.

This is the final stage of the disease, which requires hospital treatment. Medicinal and physiotherapeutic methods are used for therapy. True delirium has the following symptoms:

The patient ceases to respond adequately to external commands, speech is incoherent and quiet.
There is a decrease of 20% relative to normal blood pressure.
Frequent convulsions occur, the pupils are dilated, breathing is intermittent, trembling occurs throughout the body.
The muscles of the back of the head stop deforming.
In severe cases, the patient falls into a coma, and swelling of the brain tissue may occur, which leads to death.
There is an irreversible disruption of the functioning of many internal organs.

Somatogenic psychoses

Somatogenic psychoses (mental disorders due to somatic diseases). It is customary to distinguish between two broad groups: symptomatic psychoses and non-psychotic somatogenic disorders. According to various studies, the frequency of symptomatic psychoses varies from 0.5 to 1-1.2% of all somatic patients, i.e. very significant, given the high prevalence of internal diseases.

According to duration, somatogenic psychoses are divided into acute, or transient, subacute and protracted. Acute exogenous psychoses last from several hours to several days. These mainly include stupefaction syndromes: delirium, stupor, twilight stupefaction, amentia, oneiroid (rarely). Subacute symptomatic psychoses, lasting up to several weeks, include depression, manic-euphoric states, verbal hallucinosis, sensory delusions, hallucinatory-delusional, depressive-delusional states. Prolonged symptomatic psychoses, lasting up to several months, and in isolated cases - a year or more, can manifest themselves as chronic verbal hallucinosis, delusions with elements of systematization, catatonic-like disorders (rarely), persistent Korsakoff symptom complex. Of the acute symptomatic psychoses, the most typical is delirium in the form of abundant true visual hallucinations, illusions, false orientation, transient hallucinatory delusions, psychomotor agitation reflecting the content of hallucinatory-delusional experiences, and partial amnesia.

Mental disorders arising in connection with the pathology of internal organs and systems constitute a special branch of psychiatry - somatopsychiatry. Despite the diversity of psychopathological symptoms and clinical forms of somatic pathology, they are united by a common pathogenetic mechanisms and patterns of development.

The diagnosis of “somatogenic psychosis” is made under certain conditions: the presence of a somatic disease, a temporary connection between somatic and mental disorders, interdependence and mutual influence in their course.

Symptoms and course:

They depend on the nature and stage of development of the underlying disease, the degree of its severity, the effectiveness of the treatment, as well as on the individual characteristics of the patient, such as heredity, constitution, character, gender, age, the state of the body’s defenses and the presence of additional psychosocial harms.

Based on the mechanism of occurrence, there are 3 groups of mental disorders:

1. Mental disorders as a reaction to the very fact of the disease, hospitalization and the associated separation from the family and familiar environment. The main manifestation of such a reaction is varying degrees of depressed mood with one shade or another.

Some patients are full of painful doubts about the effectiveness of the treatment prescribed to them, about the successful outcome of the disease and its consequences. For others, anxiety and fear prevail over the possibility of serious and long-term treatment, before surgery and complications, and the likelihood of disability. Some patients are burdened by the very fact of being in the hospital and yearn for home and loved ones.

Their thoughts are occupied not so much with the illness as with problems at home, memories and dreams of being discharged. Outwardly, such patients look sad and somewhat inhibited. With a long, chronic course of the disease, when there is no hope for improvement, an indifferent attitude towards oneself and the outcome of the disease may arise. The patients lie indifferently in bed, refusing food and treatment - “it’s all the same.”

However, in such apparently emotionally inhibited patients, even with minor outside influence, anxiety, tearfulness, self-pity and a desire to receive support from others may occur.

2. The second, much larger group consists of patients in whom mental disorders are, as it were, an integral part of the clinical picture of the disease. These are patients with psychosomatic pathology, where, along with pronounced symptoms of internal diseases (hypertension, peptic ulcer, diabetes mellitus), neurotic and pathocharacterological reactions are observed.

3. The third group includes patients with acute mental disorders (psychosis). Such conditions develop either in severe acute diseases with high fever (lobar pneumonia, typhoid fever) or severe intoxication (acute renal failure), or in chronic diseases in the terminal stage (cancer, tuberculosis, kidney disease).

In the clinic of internal diseases, despite the wide variety of psychological reactions and more severe mental disorders, the most common are the following:

asthenic;
affective (mood disorders);
deviations in characterological reactions;
delusional states;
confusion syndromes;
organic psychosyndrome.

Treatment:
Should be aimed, first of all, at the underlying somatic disease, because the mental state depends on its severity. Treatment can be carried out in the hospital where the patient is, but two conditions must be met. Firstly, such a patient must be examined by a psychiatrist and give his recommendations.

Secondly, if the patient is in acute psychosis, he is placed in a separate room with round-the-clock observation and care. In the absence of these conditions, the patient is transferred to the psychosomatic department.

If the disease of the internal organs is not the cause of mental disorders, but only provoked the onset of a mental illness (for example, schizophrenia), then such a patient is also transferred to the psychosomatics department (in case of a severe somatic condition) or to a regular psychiatric hospital. Psychotropic medications are prescribed by a psychiatrist on an individual basis, taking into account all indications, contraindications, possible side effects and complications.

Prevention of somatogenic disorders should be aimed at prevention, early detection and timely treatment of somatic diseases.

Asthenia

Asthenia is a core or end-to-end syndrome in many diseases. It can be either a debut (initial manifestation) or the end of the disease.

Typical complaints include weakness, increased fatigue, difficulty concentrating, irritability, intolerance to bright light and loud sounds. Sleep becomes shallow and restless. Patients have difficulty falling asleep, difficulty waking up, and getting up unrested. Along with this, emotional instability, touchiness, and impressionability appear.

Asthenic disorders are rarely observed in their pure form; they are combined with anxiety, depression, fears, unpleasant sensations in the body and hypochondriacal fixation on one’s illness. At a certain stage, asthenic disorders can appear in any disease. Everyone knows that common colds and flu are accompanied by similar phenomena, and asthenic symptoms often persist even after recovery.

Emotional disturbances

Emotional disorders - somatic diseases are more characterized by a decrease in mood with various shades: anxiety, melancholy, apathy. In the occurrence of depressive disorders, the influence of psychotrauma (the disease itself is trauma), somatogenesis (the disease as such) and the personal characteristics of the patient are closely intertwined.

The clinical picture of depression varies depending on the nature and stage of the disease and the prevailing role of one or another factor. Thus, with a long course of the disease, depressed mood can be combined with dissatisfaction.

Stun

Stunning is a symptom of switching off consciousness, accompanied by a weakening of the perception of external stimuli. Patients do not immediately respond to questions surrounding the situation. They are lethargic, indifferent to everything happening around them, inhibited. As the severity of the disease increases, stupor can progress to stupor and coma.

A comatose state is characterized by the loss of all types of orientation and responses to external stimuli. When emerging from a coma, patients do not remember anything about what happened to them. Switching off consciousness is observed in renal, liver failure, diabetes and other diseases.

Delirium

Delirium is a state of darkened consciousness with false orientation in place, time, environment, but maintaining orientation in one’s own personality. Patients develop abundant illusions of perception (hallucinations), when they see objects and people that do not exist in reality, or hear voices.

Being absolutely confident in their existence, they cannot distinguish real events from unreal ones, therefore their behavior is determined by a delusional interpretation of the environment. There is strong excitement, there may be fear, horror, aggressive behavior, depending on the hallucinations. Patients in this regard can pose a danger to themselves and others. Upon recovery from delirium, the memory of the experience is preserved, while the events that actually occurred may fall out of memory. A delirious state is typical for severe infections and poisoning.

Oneiric state

The oneiric state (waking dream) is characterized by an influx of vivid scene-like hallucinations, often with unusual, fantastic content. Patients contemplate these pictures, feel their presence in the unfolding events (as in a dream), but behave passively, like observers, in contrast to delirium, where patients actively act.

Orientation in the environment and one’s own personality is impaired. Pathological visions are retained in memory, but not completely. Similar conditions can be observed with cardiovascular decompensation (heart defects), infectious diseases, etc.

Amentive state

An amental state (amentia is a deep degree of confusion of consciousness) is accompanied not only by a complete loss of orientation in the environment, but also in one’s own “I”. The environment is perceived fragmentarily, incoherently, and disconnectedly. Thinking is also impaired; the patient cannot comprehend what is happening. There are deceptions of perception in the form of hallucinations, which are accompanied by motor restlessness (usually in bed due to a severe general condition), incoherent speech.

Excitement may be followed by periods of immobility and helplessness. The mood is unstable: from tearfulness to unmotivated gaiety. The amental state can last for weeks and months with short light intervals. The dynamics of mental disorders are closely related to the severity of the physical condition. Amentia is observed in chronic or rapidly progressing diseases (sepsis, cancer intoxication), and its presence, as a rule, indicates the severity of the patient’s condition.

Twilight stupefaction

Twilight stupefaction is a special type of stupefaction that begins acutely and ends suddenly. Accompanied by complete loss of memory for this period. The content of psychopathological products can only be judged by the results of the patient’s behavior.

Due to profound disorientation, possible frightening hallucinations and delusions, such a patient poses a social danger. Fortunately, in somatic diseases this condition is quite rare and is not accompanied by complete detachment from the environment, unlike epilepsy.

Alcohol delirium - treatment

This condition requires not only intensive drug therapy, but also constant monitoring of the patient to ensure the safety of himself and those around him. In some cases, resuscitation measures are needed to provide emergency care. Treatment of delirium must be carried out on the basis of a psychoneurological hospital, under the supervision of a therapist or resuscitator.

Self-medication of withdrawal symptoms is strictly prohibited. An experienced doctor will be able to correctly select the list of necessary medications that will bring the patient’s condition back to normal. If the scheme is drawn up incorrectly, complications may develop. In the hospital, the following groups of medications are usually used to treat delirium:

psychotropic drugs;
means for normalizing the respiratory system;
preparations for water-salt balance;
phenotisines for adjusting blood pressure;
remedies for insomnia;
medications to normalize metabolism;
drugs to improve the functioning of the cardiovascular system;
detoxification medications.

Alcohol intoxication continues to poison the body, so it is necessary to cleanse the blood and internal organs of poisons. Against the background of alcoholism, a person often develops heart failure, damage to the liver, kidneys, and gastrointestinal tract is observed. To cleanse the body, intravenous administration of medications such as Piracetam or Unitol is often used. If mental disorders are identified during diagnosis, then antipsychotropic drugs (Renalum, Tezapam) are used.

An effective method of cleansing the blood of alcohol toxins is plasmapheresis. This is a method of plasma purification; part of it is replaced with special solutions. This helps to achieve maximum detoxification action, which clears the cells of poisons that cause withdrawal symptoms. Plasmapheresis has the following advantages in the treatment of delirium:

normalization of brain nutrition;
improvement of rheological properties of blood;
high safety of the procedure;
normalization of the immune system;
reducing the duration of treatment for alcoholism;
tangible relief of the patient’s condition during severe abstinence;
relieving the load on the liver;
the risk of exacerbation of pathologies of internal organs is reduced during the treatment of delirium and abrupt withdrawal of alcohol intake.

For these purposes, medications from the benzodiazepine group are used, which are the basis for the treatment of delirium. In medicine, they are recognized as the safest, most effective medications for therapy at all stages of alcoholism. The dosage is selected individually so that the patient is relieved of all the main signs of alcoholic psychosis, but does not experience depression of spontaneous breathing. These medications help put a person into a state of prolonged sleep if necessary.

In Russia and the CIS countries, Diazeam is more often used, and sometimes phenazepam. In most countries, Lorazepam is considered the safest and most effective, especially if the patient is diagnosed with liver disease. The use of sufficient initial doses of this group of medications helps to avoid severe agitation of a threatening nature. The traditional dosage regimen for benzodiazepines is as follows:

A bolus of 2 mg of Phenazepam or 10 mg of Diazepam is administered 3-6 times a day.
Combine benzodiazepines with antipsychotics due to insufficient antipsychotic effect.
When the required sedative effect is achieved, the administration of the drugs is stopped. This avoids depression, respiratory arrest and hypotension.

This is another main group of medications that is used in the treatment of alcoholic psychosis. In modern practice, it is used as additional measures when the above-described means are insufficiently effective. This is due to a number of disadvantages of these drugs: they cause hypotension and reduce the threshold for convulsive readiness.

Pereziazine;
Propofol;
Benperidol;
Dexmedetomidine;
Clozapine.

Cardiac glycoside

This is a group of drugs that are of plant or synthetic origin and are aimed at improving cardiac function. As a rule, they are used in the treatment of severe cases caused by impaired myocardial contractility. It manifests itself in the form of wheezing and shortness of breath.

This is one of the most terrible complications, which without treatment can be fatal. Therapy begins after the acute condition, psychosis, is relieved. The following medications are used to treat alcoholic encephalopathy:

neuroprotectors: Actovegin, Cerebrolysin;
nootronics: Elkar, Cavinton, Pantogam;
sedatives: Relanium, Phenazepam;
treatment of alcohol abuse: Colme, Teturam, Esperal.

We suggest you read: Domestic alcoholism, what is it?

Delirium tremens is a condition that not only requires monitoring of the patient in order to ensure the safety of himself and those around him, but also requires fairly intensive drug therapy. In some cases, even resuscitation measures are necessary. It is advisable to carry out treatment of alcoholic delirium on the basis of a psychoneurological hospital with the mandatory involvement of a resuscitator and therapist.

Many drugs have been proposed, but at the moment there is no single point of view on the algorithm for the treatment of alcoholic delirium.

In Europe, the standard treatment for alcoholic delirium is clomethiazole. In Russia and the USA, benzodiazepines have been and remain the drugs of choice. Their disadvantages include respiratory depression and accumulation of sedation.

In most cases, the treatment for alcoholic delirium is intravenous combination therapy with benzodiazepines and haloperidol (or droperidol).

In parallel with the relief of mental symptoms, all intensive measures aimed at eliminating somatic disorders are indicated for the treatment of alcoholic delirium. When prescribing all drugs, it is necessary to remember the degree of their influence on the nervous system and the possibility of prescribing this group to patients with chronic alcoholism.

Treatment of alcoholic delirium does not occur at home, since the patient must be hospitalized in a psychoneurological hospital. There is no single medical opinion on this matter.

In European countries, the well-known drug clomethiazole is becoming an effective solution. In Russia and the USA, treatment is based on substances belonging to the group of benzodiazepines. The drugs are characterized by a pronounced psychoactive effect and a decrease in excitability in patients. An increased dosage helps a person fall asleep soundly.

In order to establish water-salt homeostasis, drugs called sodium bicarbonate and rheopolyglucin are used. To eliminate pulmonary and cerebral edema during treatment, specialists use mannitol. Vitamins belonging to groups C, PP and B are required for indication.

The use of medications belonging to a different type depends on the symptoms. In any case, the course of therapy is prescribed exclusively by the attending physician. It is highly recommended not to try to get rid of delirium tremens on your own. By self-medicating and not calculating the dosage, you can only cause harm to yourself. Also, if you do not have a prescription in hand, the drug will not be sold.

Treatment for delirium tremens is usually compulsory. The patient's relatives are forced to take this step at the request of the relatives. The treatment process is carried out by qualified doctors. In this case, the situation is developing in three possible directions.

The weakened body of a person who regularly drinks alcohol is weakened, and additional drug-based therapy can have a negative impact on it. However, leaving the patient in a state of madness is dangerous for the lives of those around him.

Upon reaching the third stage of delirium tremens, the case is highly likely to end in death. Therefore, it is better to try to save a loved one, even taking a conscious risk.

Delirium tremens is a condition that requires immediate medical attention as it can lead to death.

In the treatment of alcoholic delirium, psychotropic and detoxification drugs are used, as well as drugs that normalize water-salt balance, metabolism, cardiac activity and respiration.

To relieve psychomotor agitation, seduxen, diphenhydramine or sodium hydroxybutyrate are administered.

Of the psychotropic medications in the treatment of alcoholic delirium, Relanium, droperidol or haloperidol are most often used - they temporarily suppress agitation and hallucinations.

In order to eliminate intoxication of the body, intravenous drips with glucose, hemodez, rheopolyglucin are placed, and hemosorption is carried out.

Vitamins are also prescribed, and the activity of the heart is supported with the help of corglycone and cordiamine.

Since alcoholic delirium is characterized by a highly agitated state, attacks should not be stopped at home. Treatment takes place in intensive care, a drug treatment clinic or a mental hospital and lasts about a week, sometimes less. To begin with, intoxication is carried out, and there are three stages of treatment:

Sanitary supervision: placement in a ward with daylight (strong lighting is an irritant, and darkness increases delusions and hallucinations), isolation from society. Treatment is aimed at eliminating excitability and insomnia, because normalization of sleep is the main sign that the patient is being cured.
Relief of agitation using benzodiazepine medications, which are tranquilizers. Medicines are given in large doses.
The use of medications to maintain heart function: from ascorbic acid and glucose to nicotinic acid, depending on the complexity of the case.

Delirium: types and clinical symptoms

Depending on the etiological reasons that caused disturbances of consciousness, the state of delirium is classified into different types. Moreover, each type of disorder has its own symptoms, so different approaches are required to remove the patient from delirium. In medical practice, delirium is most often recorded:

medicinal (psychopharmacological);
alcoholic;
narcotic.

Psychopharmacological delirium

Drug-induced delirium is a consequence of the illiterate use of psychopharmacological drugs. Symptoms of mental disorders occur when using antipsychotics and antidepressants with a pronounced anticholinergic effect. As a rule, mental disorder is a consequence of the use of high doses of drugs or is the result of an overdose of drugs. The prognosis of the disorder is favorable in most cases.

The primary symptoms of this type of consciousness disorder are causeless anxiety, obsessive fear, fussiness and chaotic actions, and various sleep problems. If delirium is initiated by taking typical antipsychotics, the onset of the disorder is marked by extrapyramidal syndromes - motor disorders, in particular: tremor. On the second day, patients experience persistent insomnia. Dryness of the internal membranes of hollow organs is recorded. Increased sweating is detected. There are surges in blood pressure and heart rhythm disturbances.

If delirium is a consequence of an overdose of antidepressants, the onset of the disorder is characterized by a variety of autonomic disorders. Episodes of disturbance of consciousness often occur at the time of awakening and falling asleep. During an attack, the patient is overcome by an influx of visual or auditory hallucinations. The person becomes distracted and fussy. The ability to navigate what is happening is slightly impaired. Memory loss in drug-induced delirium is extremely rare.

In severe cases of the disorder, symptoms develop rapidly and are extremely expressive. Clinical manifestations of the advanced phase are similar to the symptoms that occur during delirium tremens.

Patients are in an agitated state and experience severe fear. Patients experience vivid, intense visual and auditory hallucinations. Some people experience distortion of tactile perception. Anxiety may cause them to “hide” from or “run away” from frightening objects.

In some cases, dryness and redness of the skin is observed. A person experiences an unquenchable thirst. He complains of delayed urination and defecation.

The main condition for the treatment of psychopharmacological delirium is the complete abolition of prescribed drugs. Therapy begins with drip intravenous administration of glucose solution and sodium chloride solution. In parallel with this, injections of nootropic drugs and B vitamins are carried out. The remaining steps in the drug treatment of psychopharmacological delirium depend specifically on the drug, the overdose of which caused disturbances of consciousness.

Consequences of alcoholic delirium

Alcoholic delirium develops due to the consumption of alcohol, which is a toxin that is poisonous to the body. If binge alcoholics take a break from drinking, they will experience delirium tremens. This disorder causes various diseases, including fatal ones. The consequences of delirium are as follows:

Cardiomyopathy (fatal in almost five percent of cases).
Pneumonia.
Kidney failure.
Pancreatitis.
Brain swelling.
Salt imbalance.

Abrupt refusal during pathological intoxication from drinking alcoholic beverages leads to dangerous consequences. The most dangerous complication is cerebral edema, which leads to death. This can only be avoided with timely diagnosis and medical care. Delirium tremens becomes a catalyst for the development of various diseases, for example:

pancreatitis;
pneumonia;
renal failure;
alcoholic cardiomyopathy;
rhabdomyolysis;
violation of vitamin metabolism;
failure of water-salt balance;
acid-base disorders;
cerebral edema.

Alcoholic delirium is fraught with disruptions in the functioning of all major organ systems. Among the most common complications:

inflamed pancreas or lungs;
impaired heart function;
the appearance of swelling of the brain;
kidney failure.

This is just a small list of the consequences of delirium alcoholism. It is important that assistance is provided in a timely manner and that chronic diseases of the kidneys, liver, etc. do not develop.

The manifestation of delirium tremens in chronic alcoholics, as a rule, occurs after the end of the binge. You can recognize a “squirrel” by hallucinations that can drive an unhealthy and inadequate person to self-harm.

In order to overcome the disorder, you can use medication. However, treatment cannot always save the patient and lead to complete healing. Therefore, if possible, it is better not to succumb to alcohol addiction.

Classification of mental disorder

In ICD-10, all types of diseases are divided into 2 large groups - delirium that occurs after taking psychoactive substances, and psychoses of other origins. In medical practice, a simple classification is used, focusing on the etiology (origin) of the disease:

Alcoholic. It occurs after giving up alcohol after a long binge (we talked about this disease in a separate article). Classic delirium is one of the types of such psychosis. It is characterized by depressed mood and fearfulness. Drug delirium develops similarly to alcohol delirium.
Hypnagogic. Visual and auditory pseudohallucinations occur during the period of falling asleep or waking up.
Postoperative – often occurs in surgical patients. More typical for older people. Occurs after anesthesia.
Cholinergic. Psychosis develops with an overdose of anticholinergics - dope, henbane, belladonna, Diphenhydramine. These substances include anti-allergenic agents. Cyclodol delirium is a subtype of cholinolytic delirium, as it develops under the influence of a strong anticholinergic drug – cyclodol.
Traumatic. Occurs in people with brain injury. The disorder is included in the group of organic deliriums that are not caused by the effects of psychoactive substances.
Infectious (febrile). Occurs with pneumonia, typhoid, and some childhood infections. It comes suddenly - the patient shows anxiety, refuses to eat, moans, cries, and cannot stand bright light.
Vascular. Characterized by nocturnal attacks in people with coronary heart disease and the development of a micro-stroke. Delirium occurs due to hypertension and atherosclerosis.
Senile. Develops in half of elderly patients who have dementia (dementia). Manifests itself as disturbances in memory and thinking, spatial and temporal orientation.

Separately from other types, delirium that is triggered by diseases of internal organs, poisoning with alcohol or salts of mercury, lead, and antimony is considered. This form of psychosis is characterized by deep clouding of consciousness. The patient practically does not react to external stimuli. During an attack, he performs basic movements (grasping, stroking) and quietly mutters incoherent sentences. Lack of help results in coma and stupor for the patient, and increases the risk of death. After returning to normal, the person does not remember anything.

Delirium is classified according to the nature of its course:

abortive – manifestations of the disease are erased, transient,
acute – develops rapidly, and manifestations are characterized by increased brightness,
prolonged - clinical signs develop gradually, critical thinking remains, hallucinations prevail over real perception at night.

Specific clinical manifestations of psychoses:

Professional delirium. During attacks, the patient performs movements similar to those he makes at work.
Auditory – symptoms are dominated by auditory hallucinations. This type of psychosis is a form of alcoholism.
Oneiric is a severe disturbance of consciousness with hallucinations that occurs after mild mental disorders.
Delirium of siege - refers to alcoholic psychosis, in which the patient barricades himself in a room, protecting himself from frightening visions.
Furious - a person reacts aggressively to others.
Schizophrenoid. It is characterized by some symptoms of schizophrenia - periodic causeless laughter, the desire to harm oneself, persistent hallucinations, silent agitation, accompanied by aggressive actions.
Epileptic – developing after epileptic seizures.

Delirium is a syndrome that often occurs in people with alcoholism and mental disorders. Psychosis of varying severity is detected in 10% of patients in surgical departments undergoing inpatient treatment. Up to 30% of patients in the intensive care unit also experience postoperative delirium. It develops in 20% of patients with severe burns. Brain injury or a previous medical history of delirium increases the risk of relapse.

The prevalence of the described mental disorder among older people is increasing. Non-resuscitation patients suffer in 11-40% of cases, resuscitation - in 60-80%. The course of the underlying disease with the development of delirium worsens the prognosis for recovery. The presence of this disease in the medical history is associated with a large number of complications and increases the risk of death within 2 years after discharge from a medical institution.

If delirium develops in people with dementia, the risk of death within a year of discharge doubles. Psychosis often causes long-term cognitive impairment (thinking, speech, memory, attention). The quality of life of the patient after discharge from the hospital in most cases decreases.

Sanitary supervision

This is a mandatory condition when treating a patient with obvious signs of alcohol withdrawal due to chronic alcoholism. With abrupt cessation of use, disturbances of consciousness are observed. Attacks of delirium are accompanied by autonomic disorders and delusions of persecution, and are characterized by visual hallucinations that are at odds with reality.

Deep sedation will be performed, and the patient will be connected to a ventilator until the episodes of delirium end.
The person remains on spontaneous breathing; acute psychosis is relieved with the help of medications.

Treatment

Before the ambulance arrives, the patient’s movements should be limited so that he does not harm himself or others. To get rid of symptoms, complex therapy is chosen. The scope of treatment measures is prescribed taking into account the origin of psychosis and its clinical manifestations. During the day, they try to keep the patient in a cheerful state. Medical staff monitors the functioning of organs and systems, which helps prevent the development of complications.

Treatment for delirium includes:

Maintaining optimal water balance.
Suppression of infection and resulting poisoning.
Stabilization of the heart and blood vessels, liver and kidneys.
Use of specific antidotes in case of intoxication.
The use of measures aimed at improving cerebral circulation.
The use of antipsychotics to relieve symptoms of psychosis.
Prescription of medications with anticonvulsant and sedative effects.

Frightened, hyperexcited and aggressive patients are calmed with sedatives, which helps prevent complications and prevent accidents.

There is no one remedy for all types of delirium. Many psychiatrists prefer to use Haloperidol to relieve symptoms. It is used for many delusional disorders and diseases accompanied by hallucinations. Haloperidol has a sedative and antipsychotic effect (eliminates anxiety, perception disorders and delusions). The amount of the drug is calculated based on body weight and age. The initial dose is 2-10 mg intramuscularly. If symptoms persist, it is reintroduced every hour.

Measures to reduce stress and monitor the condition help prevent the disease from progressing. It is important to reduce the number of irritating factors and regulate sleep and wakefulness. In most cases, delirium is not life-threatening, but it develops against the background of serious illnesses that require surgical treatment.

Along with Haloperidol, Chlorpromazine and Risperidone are highly effective. Features of medications for the treatment of delirium:

no significant differences were found between Haloperidol, Risperidone and Olanzapine,
Quentiapine helps reduce the duration of psychosis,
The drug Aripiprazole is highly effective in eliminating the symptoms of delirium.

Before choosing a drug, the doctor carefully assesses the condition of the body. In some cases, less common medications are more effective. For example, Quentiapine is used to treat psychosis in patients with Parkinson's disease. If there is no dangerous agitation, psychopharmacological drugs are not used.

For disorders of brain activity, nootropics Piracetam 20% (daily volume 30 ml) are used. The therapy is supplemented with vitamins - nicotinic and ascorbic acid, vitamin-like compounds of group B - food additive choline, inositol (found in beans, nuts, wild rice), para-aminobenzoic acid (found in mushrooms, vegetables, wheat flour).

Cranocerebral hypothermia helps prevent hypoxia (oxygen starvation) and cerebral edema - passing cold water through a rubber helmet and applying ice packs to the head.

To prevent clogging of the respiratory tract with vomit, the oral cavity is cleaned. Severe patients are turned on the couch every 2-3 hours, excluding the development of pneumonia. Vomit and mucus are sucked out of the respiratory tract. For pneumonia, antibiotics are prescribed.

If the temperature rises steadily, the patient is cooled with a fan and rubbed with a towel soaked in alcohol. Ice packs are placed on the area of the great vessels.

For an enlarged liver, a 1% solution of choline chloride in an isotonic sodium chloride solution is administered intravenously at 2-3 g/day. Sirepar is also prescribed intramuscularly and Metadoxil intravenously.

While in the hospital, the patient's contact with other people is limited and complete rest is ensured. If necessary, therapy is prescribed to restore the activity of the respiratory and cardiovascular systems.