Signs and symptoms of<unk>  withdrawal occur primarily in the central nervous system. The severity of withdrawal can vary from mild symptoms such as sleep disturbances and anxiety to severe and life-threatening symptoms such as<unk> ic hallucinosis, delirium tremens, and autonomic instability. Withdrawal usually begins 6 to 24 hours after the last drink. It can last for up to one week. To be classified as<unk> , patients must exhibit at least two of the following symptoms: increased hand tremor, insomnia, nausea or vomiting, transient hallucinations (auditory, visual or tactile), psychomotor agitation, anxiety, tonic–clonic seizures, and autonomic instability. The severity of symptoms is dictated by a number of factors, the most important of which are degree of<unk>  intake, length of time the individual has been using<unk> , and previous history of<unk>  withdrawal. Symptoms are also grouped together and classified: *<unk>  hallucinosis: patients have transient visual, auditory, or tactile hallucinations, but are otherwise clear. * Withdrawal seizures: seizures occur within 48 hours of<unk>  cessations and occur either as a single generalized tonic-clonic seizure or as a brief episode of multiple seizures. * Delirium tremens: hyperadrenergic state, disorientation, tremors, diaphoresis, impaired attention/consciousness, and visual and auditory hallucinations. This usually occurs 24 to 72 hours after<unk>  cessation. Delirium tremens is the most severe form of withdrawal and occurs in 5 to 20% of patients experiencing detoxification and 1/3 of patients experiencing withdrawal seizures. Progression Typically the severity of the symptoms experienced depends on the amount and duration of prior<unk>  consumption as well as the number and severity of previous withdrawals. Even the most severe of these symptoms can occur as soon as 2 hours after cessation; this rapid onset alongside the syndrome's unpredictability necessitates either pre-planned hospitalization, treatment coordinated with a doctor, or at the very least rapid access to medical care; a supporting system of friends or family should also be introduced prior to addressing detoxification. In many cases, however, symptoms follow a reasonably predictable time frame as exampled below: Acute confusional state caused by<unk>  withdrawal, also known as delirium tremens Six to 12 hours after the ingestion of the last drink, withdrawal symptoms such as shaking, headache, sweating, anxiety, nausea, or vomiting occur. Other comparable symptoms may also occur in this period. Twelve to 24 hours after cessation, the condition may progress to such major symptoms as confusion, hallucinations (with awareness of reality), tremor, agitation, and similar ailments. At 24 to 48 hours following the last ethanol ingestion, the possibility of seizures should be anticipated. Meanwhile, none of the earlier withdrawal symptoms will have abated. Seizures carry the risk of death for the person who consumes excess<unk> . Although the person's condition usually begins to improve after 48 hours, withdrawal symptoms sometimes continue to increase in severity and advance to delirium tremens, which is characterized by hallucinations that are indistinguishable from reality, severe confusion, seizures, high blood pressure, and fever that can persist anywhere from 4 to 12 days. Protracted withdrawal A protracted<unk>  occurs in many people with an<unk>  use disorder when withdrawal symptoms continue beyond the acute withdrawal stage but usually at a subacute level of intensity and gradually decreasing with severity over time. This syndrome is sometimes referred to as the post-acute-withdrawal syndrome. Some withdrawal symptoms can linger for at least a year after discontinuation of<unk> . Symptoms can include a craving for<unk> , inability to feel pleasure from normally pleasurable things (known as anhedonia), clouding of sensorium, disorientation, nausea and vomiting or headache. Insomnia is a common protracted withdrawal symptom that persists after the acute withdrawal phase of<unk> . Insomnia has also been found to influence relapse rate. Studies have found that magnesium or trazodone can help treat the persisting withdrawal symptom of insomnia in recovering people with<unk>  use disorder. Insomnia can be difficult to treat in these individuals because many of the traditional sleep aids (e.g., benzodiazepine receptor agonists and barbiturate receptor agonists) work via a GABAA receptor mechanism and are cross-tolerant with<unk> . However, trazodone is not cross-tolerant with<unk> . The acute phase of the<unk>  can occasionally be protracted. Protracted delirium tremens has been reported in the medical literature as a possible but unusual feature of<unk>  withdrawal.
Alcohol withdrawal syndrome
Epilepsy
Benzodiazepine withdrawal syndrome
Drug withdrawal
Post-acute-withdrawal syndrome
Nicotine withdrawal
Opioid withdrawal
Cocaine intoxication