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Alcohol Tremors: Causes, Signs, and Treatment

Alcohol Tremors: Causes, Signs, and Treatment

Alcohol tremors are commonly experienced while one tries to stop alcohol consumption. However, professional help and medications can help manage the tremors.

Alcohol Use Disorder (AUD) is mainly characterized by the increased tolerance for alcohol consumption and the presence of withdrawal symptoms if someone tries to avoid alcohol intake. About 50% of those with an AUD history experience withdrawal symptoms on discontinuing alcohol intake. Alcohol withdrawal symptoms may include anxiety, headaches, vomiting, insomnia, hallucinations, seizures, fever, and high blood pressure. Alcohol tremors, also known as alcohol shakes, usually occur as a response to alcohol abstinence and start to appear as early as six hours after the last drink. Alcohol tremors are also considered an early sign of delirium tremens, a severe complication of alcohol withdrawal. Alcohol tremors are characterized by involuntary shaking or trembling of any part of the body, mainly the hands or legs. The duration of tremors and their severity depends on circumstances like how abruptly one stopped taking alcohol; however, they may last one to two weeks or more. Certain medications and self-help tips can help manage alcohol withdrawal symptoms, reducing the risk of alcohol tremors. 

Confidant Health provides a virtual alcohol rehab program and Medication Assisted Treatment (MAT) to help you overcome alcohol use disorder with minimal chances of experiencing alcohol tremors or other withdrawal symptoms. Confidant Health’s online alcohol treatments can help you get back to a healthy lifestyle without alcohol intake.

What are alcohol tremors?

Alcohol tremors are the uncontrolled shaking or involuntary movement of one of the parts of the body, and they are a key symptom of alcohol withdrawal. If left unmanaged, alcohol tremors may progress to a life-threatening condition called delirium tremens. Typically, alcohol tremors are present in the hands; however, they may also occur in the legs or arms. Furthermore, alcohol tremors may be intermittent or continuous.

For people who are in detox while quitting alcohol consumption, alcohol tremors are barely noticeable. Why? Because certain medications and therapies are used to control these involuntary movements and prevent delirium tremens.

Causes of alcohol tremors

The following are the main causes that can result in alcohol tremors.

Abrupt cessation of alcohol use

Heavy alcohol use causes a change in brain chemistry as when alcohol is taken, it reduces brain functioning and its activity. Regular alcohol use basically alters neurotransmitters like gamma-amino-butyric acid (GABA) and glutamate. When alcohol use is stopped, the brain responds to this condition by increasing nerve activity in order to maintain body homeostasis. When alcohol use is abruptly stopped, the brain doesn't stop to deliver increased nerve activity due to an imbalance of neurotransmitters. This results in tremors, hyperactivity in the body, and other withdrawal symptoms. Once rehabilitation is completely done, tremors automatically resolve. In some cases, heavy alcohol use leads to permanent liver, nerve, and brain damage which leads to permanent tremors.

Chronic alcohol use

Consumption of alcohol for extended periods can also lead to alcohol tremors. A study has revealed that 47% of people struggling with alcohol misuse had a postural tremor and functional disability occurred in 17 % of those. 

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Signs and symptoms of alcohol tremors

At first, mild withdrawal symptoms may occur; however, as the time from quitting alcohol passes, the severity of symptoms usually increases. Alcohol withdrawal symptoms usually start to appear six hours after the last drink and peak around 14-48 hours. The following symptoms mainly present alcohol tremors. 

Typical Symptoms

Typical symptoms of alcohol tremors are

  • Involuntary movement of any parts of the body
  • Muscle fatigue of the affected part
  • Generalized weakness

Early delirium tremens

  • Fever 
  • Insomnia 
  • Hyperactivity 
  • Excessive sweating 
  • Pale skin 
  • Rapid heartbeat
  • Sleep disturbances 
  • Extreme muscle contractions 
  • Shallow breathing 
  • Angry behavior 
  • Shaking of hands, arms, legs, and feet.
  • Dehydration.

Later, delirium tremens usually present with hallucinations, delusions, and tremors. 

Diagnosis of alcohol tremors 

Your physician may need to perform a general physical examination and neurological examination to diagnose alcohol tremors. Moreover, your alcohol history, the time since you are alcohol-free, and when the tremors first appear can also help diagnose alcohol tremors.

In the physical and neurological examination, your physician may look for any abnormal eye movements, heart rhythms, fever, heartbeat, signs of dehydration, and shaky hands. Moreover, your doctor may also run some blood tests to rule out other causes of tremors before making a provisional diagnosis of alcohol tremors.

Treatment of alcohol tremors 

The treatment of alcohol tremors depends upon the severity of the condition. It may involve using certain medications and psychotherapies to decrease the symptoms, reduce the alcohol cravings and avoid the progression of tremors to delirium tremens. Let’s discuss the main treatment options available for alcohol tremors.

Medications for alcohol tremors

Furthermore, supportive treatment with antipyretics and vitamin supplementation can also help in the symptomatic treatment of alcohol tremors.


Alcohol withdrawal symptoms, including alcohol tremors, are also associated with psychological stress and anxiety. Thus, the therapies used to reduce mental stress, such as CBT (Cognitive Behavioral Therapy), DBT (Dialectical Behavioral Therapy), and group therapy, can also help decrease the likelihood of alcohol tremors.

Lastly, a family can play an important role in helping an individual overcome drinking habits and alcohol use disorder. Family counseling can provide family support to cope with alcohol withdrawal symptoms and other problems related to quitting alcohol.

Self Help Tips

Following are some self-help tips that can be helpful in overcoming alcohol dependence and withdrawal symptoms.

  • Engage yourself in a hobby such as cooking, cycling, or gardening. 
  • Participate in yoga and medication.
  • Engage yourself in reading or writing activities.
  • Listen to motivational speakers and read inspirational stories.
  • Avoid junk food and eat healthy food like lean proteins, whole grains, fruits, and vegetables.
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How to prevent alcohol tremors?

Quit alcohol

As alcohol misuse is the main cause of alcohol-related conditions, it would be most logical to quit alcohol if you want to avoid those conditions.

Drink plenty of water

Staying hydrated and drinking plenty of water can increase the volume of fluid in the body, reducing the amount of alcohol per liter of body fluids.That’s why it is often recommended to drink plenty of water when taking alcohol.

Professional Help

Alcohol tremors can be prevented by seeking professional help when starting to quit alcohol consumption. An experienced healthcare professional may elaborate on different ways and prescribe some medications to avoid alcohol tremors. Confidant Health is a virtual platform where you can consult a licensed consultant to help you throughout your journey toward an alcohol-free life. 

When to seek medical help?

As discussed above in this article, alcohol tremors can sometimes lead to a life-threatening condition called delirium tremens. Therefore, it is vital to seek medical help immediately if one experiences alcohol tremors.

  • If the condition is severe, the inpatient department may provide treatment involving intravenous medications and fluids.
  • If the condition is manageable, the outpatient department may prescribe medications and therapies to overcome withdrawal symptoms.

Consult with Confidant Health’s Professionals

Confidant Health is an online platform that provides a virtual digital rehab program involving online sessions to help you overcome alcohol misuse and dependence. Furthermore, this platform offers Medication Assisted Treatment in which an experienced healthcare professional prescribes medications and provides behavioral therapy sessions to cope with alcohol use disorder (AUD). You can download Confidant Health’s app to consult with a licensed consultant experienced in dealing with alcohol misuse and related disorders.

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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