Serum magnesium level and severity of delirium in alcohol withdrawal state

Objectives: Chronic alcohol consumption is associated with nutritional deficiency including micronutrients such as magnesium. Alcohol dependent patients often develop delirium during withdrawal. The relationship between low magnesium levels and delirium tremens has not been well studied. This study aims to estimate serum magnesium levels in alcohol withdrawal state and to study its association with severity of delirium. Methodology: This is a prospective study that involved 60 alcohol dependent patients in withdrawal state. Diagnosis was made using the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria. Alcohol withdrawal symptoms were rated using the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). The severity of delirium was rated using the Delirium Rating Scale-revised-98 (DRS-R-98). Serum magnesium was estimated using colorimetric end point method. Results: Twenty per cent (n=12) of the subjects in alcohol withdrawal state had shown hypomagnesaemia. A significant increase in serum magnesium was seen from day one to day five. No significant relationship was noticed for serum magnesium level and severity of delirium. Conclusion: A significant number of alcohol dependent patients during withdrawal demonstrate hypomagnesaemia. Correction of serum magnesium level may be considered in patients with delirium tremens.