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All about delirium causes of delirium risk factors for delirium symptoms of delirium diagnosis of delirium treatment for delirium prevention of delirium

What causes delirium?

There are a large number of possible causes of delirium. Metabolic disorders are the single most common cause, accounting for 20–40% of all cases. This type of delirium, termed "metabolic encephalopathy," may result from organ failure, including liver or kidney failure. Other metabolic causes include diabetes mellitus, hyperthyroidism and

hypothyroidism, vitamin deficiencies, and imbalances of fluids and electrolytes in the blood. Severe dehydration can also cause delirium.

Drug intoxication ("intoxication confusional state") is responsible for up to 20% of delirium cases, either from side effects, overdose, or deliberate ingestion of a mind-altering substance. Medicinal drugs with delirium as a possible side effect or result of overdose include:

  • Anticholinergics, including atropine, scopolamine, chlorpromazine (an antipsychotic), and diphenhydramine (an antihistamine)
  • Sedatives, including barbiturates, benzodiazepines, and ethanol (drinking alcohol)
  • Antidepressant drugs
  • Anticonvulsant drugs
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and acetaminophen
  • Corticosteroids, including prednisone
  • Anticancer drugs, including methotrexate and procarbazine
  • Lithium
  • Cimetidine
  • Antibiotics
  • L-dopa

Delirium may result from ingestion of legal or illegal psychoactive drugs, including:

  • Ethanol (drinking alcohol)
  • Marijuana
  • LSD (lysergic acid diethylamide) and other hallucinogens
  • Amphetamines
  • Cocaine
  • Opiates, including heroin and morphine
  • PCP (phencyclidine)
  • Inhalants

Drug withdrawal may also cause delirium. Delirium tremens, or "DT's," may occur during alcohol withdrawal after prolonged or intense consumption. Withdrawal symptoms are also possible from many of the psychoactive prescription drugs.

Poisons may cause delirium ("toxic encephalopathy"), including:

  • Solvents, such as gasoline, kerosene, turpentine, benzene, and alcohols
  • Carbon monoxide
  • Refrigerants (Freon)
  • Heavy metals, such as lead, mercury, and arsenic
  • Insecticides, such as Parathion and Sevin
  • Mushrooms, such as Amanita species
  • Plants such as jimsonweed (Datura stramonium) and morning glory (Ipomoea spp.)
  • Animal venoms

Other causes of delirium include:

  • Infection
  • Fever
  • Head trauma
  • Epilepsy
  • Brain hemorrhage or infarction
  • Brain tumor
  • Low blood oxygen (hypoxemia)
  • High blood carbon dioxide (hypercapnia)
  • Post-surgical complication

More information on delirium

What is delirium? - Delirium is a syndrome characterized by the rapid onset of variable and fluctuating changes in mental status caused by physiologic consequences of a medical disturbance.
What causes delirium? - There are a large number of possible causes of delirium. Metabolic disorders are the single most common cause. Drug intoxication is another cause.
What're the risk factors for delirium? - Risk factors include advanced cancer or other serious illness, having more than one disease, older age, previous mental disorder.
What're the symptoms of delirium? - The symptoms of delirium include a clouding of awareness and consciousness, confusion, hallucinations, memory deficits, sleep disturbances.
How is delirium diagnosed? - Delirium is a clinical diagnosis. Diagnosis is based on observed changes in mental status that are related to some underlying medical disturbance.
What's the treatment for delirium? - Treatment of delirium begins with recognizing and treating the underlying cause. Delirium itself is managed by reducing disturbing stimuli.
How to prevent delirium? - Prevention of delirium is focused on treating or avoiding its underlying causes. The most preventable forms are those induced by drugs.
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