Delirium tremens timing.

• A. Delirium tremens occurs within minutes after cessation.
• B. Delirium tremens occurs ~48-72 hours after cessation in severe dependence.
• C. Delirium tremens occurs after several weeks.
• D. Delirium tremens occurs only with mild dependence.

Answer: (B)

Delirium tremens is a severe alcohol withdrawal phenomenon that typically appears after stopping alcohol in people with heavy, long-term use. The classic timing is about 2 to 3 days after the last drink, commonly described as roughly 48–72 hours, especially in those with severe dependence. This window reflects the period when the brain, accustomed to constant alcohol’s depressant effects, sharply rebounds with increased neural activity and autonomic instability, leading to delirium, agitation, tachycardia, fever, and confusion.

Understanding the timing helps distinguish DTs from other withdrawal symptoms. It doesn’t occur within minutes of cessation, because delirium requires time for the withdrawal cascade to escalate. It isn’t a problem that shows up after weeks, since that would be outside the acute withdrawal period. And it’s not limited to mild dependence; DTs are linked to more severe dependence and a higher risk of developing this dangerous syndrome. Therefore, the described timing of approximately 48–72 hours after cessation in someone with severe dependence best matches when delirium tremens tends to occur.