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Delirium tremens

05.09.2013 | Sekce: Zdravotní

Delirium tremens je alkoholová psychóza. Jedná se o život ohrožující stav, 5 - 15 % alkoholiků, kteří se do tohoto stádia dostanou, na jeho následky zemřou.

 

 

Delirium tremens, nebo také alkoholové delirium, je jednou z alkoholových psychóz. Delirium tremens je nejtěžším stavem abstinenčního syndromu  - nastane tedy při přerušení užívání alkoholu na něm závislými. Jedná se o život ohrožující stav, 5 - 15 % alkoholiků, kteří se do tohoto stádia dostanou, na jeho následky zemřou.

 

RÁMEČEK

Delirium tremens je alkoholová psychóza. Latinský název lze volně přeložit jako „třesoucí se šílenství" - název sám napovídá, jaké jsou hlavní příznaky. Jedná se o život ohrožující stav, 5 - 15 % alkoholiků, kteří se do tohoto stádia dostanou, na jeho následky zemřou.

 

 

     Delirium tremens se může objevit i po prudkém a náhlém vysazení benzodiazepinů (Diazepam, Rivotril, Neurol.) nebo benzodiazepinu a alkoholu současně. Nejčastěji v situacích, kdy je alkohol popíjen (nebo benzodiazepinový lék užíván) dlouhodobě, denně. Po tomto prudkém vysazení alkoholu, nebo benzodiazepinu, může dojít k prostému odvykacímu stavu s třesem, pocením, nevolností, křečemi a klidně i záchvaty, které se projevují stejně jako epilepsie.

     V další fázi se mohou začít objevovat živé a někdy docela hororové sny, mohou se objevovat i první halucinace a iluze. Ve vlastním deliriu se mohou kombinovat psychické příznaky s iluzemi či halucinacemi nejrůznějšího charakteru s dezorientací místem, časem, osobou. Dále se mohou objevovat bludy například s paranoidními obsahy (jako "stíhy") v kombinaci se strachem, úzkostí, napětím. Neklid může být i v noci a může se objevovat i masivní agresivita. To vše může být doplněno pestrými a život ohrožujícími tělesnými příznaky s pocením, třesem, neklidem, bušením srdce, zvýšeným tlakem a podobně. Rozhodně není radno již obyčejný odvykací stav podceňovat, protože jistotu, že se nezvrhne do delirantního stavu, nemůže mít v tu chvíli nikdo.

 

RÁMEČĚK

Jaké halucinace mohou např. vzniknout při deliriu: myši, kočky, pavouci, jeden z pacientů Dr. Nešpora měl pocit, že jede rychlíkem do Bagdádu, jiný halucinoval marťany, další viděl, jak mu oknem do pokoje vniklo velké množství malých Leninů, jeden pacient měl pocit, že jej po bytě honí vlastní vysavač.

 

 

HANA Laurentová, TP SANANIM

*Text byl vypracován za přispění MUDr. Dušana Randáka

 

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