Delirium - Specialists and Information

The term "delirium" describes a temporary mental disorder characterized by confusion. It can occur when alcohol-dependent patients stop drinking, as well as after surgery.

Below you will find further information and a selection of specialists for the treatment of delirium.

What is delirium?

Delirium (also known as a state of confusion) is a temporary mental disorder that affects consciousness, orientation, and perception. 

Physical symptoms such as sweating, high blood pressure, or an elevated heart rate are also typical.

Symptoms of delirium

The following symptoms may be present in delirium:

• Impaired consciousness and orientation: drowsiness and disorientation regarding time and place
• Perceptual disturbances: Hallucinations and seeing or hearing things that aren’t there, such as white mice scurrying across the room.
• Thought disturbances: These include delusional beliefs that someone is poisoning or threatening them. Confusion is also typical.
• Physical restlessness, increased startle response, depressive symptoms, and anxiety
• Disturbances in the sleep-wake cycle, with symptoms worsening at night
• Autonomic symptoms such as sweating, high blood pressure, and rapid pulse

The onset of delirium is usually acute. Symptoms typically fluctuate throughout the day, with periods of improvement and deterioration.

What are the causes of delirium?

Experts estimate that the following patients will develop delirium during their hospital stays.

The figures are:

• 10 to 15 percent of patients in surgical wards 
• 15 to 25 percent of patients in medical wards, and 
• 30 to 40 percent of all patients over the age of 65 

Delirium is particularly common in patients with certain conditions: 

• Burns: 20 to 30 percent
• AIDS: 30 percent
• Heart surgery: 70 percent
• Hip replacement surgery following a fracture: 40 to 50 percent

Delirium is common among patients fighting for their lives in intensive care units @ sudok1 /AdobeStock

The following risk factors are associated with the development of delirium:

• Age (especially the elderly and young children)
• Pre-existing brain damage (e.g., Alzheimer’s disease, vascular dementia)
• Alcohol dependence
• Diabetes
• Malnutrition
• Tumors and other serious physical illnesses
• Treatment with multiple medications
• Fever
• A previous episode of delirium

The most common causes of delirium are:

• Excessive doses of medications, such as certain antibiotics or antidepressants
• Sedatives (benzodiazepines)
• Parkinson’s medications
• Cortisone
• Antiepileptic drugs
• Withdrawal from drugs (especially alcohol) and medications (especially sedatives such as benzodiazepines, e.g., Valium® or Tavor®)
• Brain disorders
• Severe physical illnesses

Alcoholic delirium usually occurs during alcohol withdrawal @ Nawarit /AdobeStock

Treatment of delirium

Delirium is always a medical emergency, so prompt hospitalization is necessary. 

The key to treatment is quickly identifying the cause of the delirium so that treatment can be initiated immediately.

There are various treatment approaches. 

Some are aimed at treating the underlying physical causes, such as:

• Regulating fluid and electrolyte balance 
• Monitoring blood sugar
• Cardiovascular monitoring
• Gastric protection

Other measures address psychological symptoms. 

These include:

• Treatment of delusions, hallucinations, and agitation with potent antipsychotics such as Haldol® or Risperdal®
• Treatment of sleep disturbances with sedating antipsychotics such as Eunerpan®
• There are specific treatment approaches for managing delirium associated with alcohol dependence