In delirium tremens, which electrolyte abnormality is more common?

• A. Hyponatremia
• B. Hypomagnesemia
• C. Hyperkalemia
• D. Hypernatremia

Answer: (B)

Low magnesium is the electrolyte abnormality most commonly seen in delirium tremens. Chronic alcohol use tends to deplete magnesium through poor dietary intake, malabsorption, GI losses, and increased renal excretion, and withdrawal can amplify these effects. Magnesium helps stabilize neuronal membranes and modulates excitability; when it is deficient, there’s increased neuronal firing, which contributes to tremors, agitation, seizures, and autonomic instability seen in delirium tremens. Replenishing magnesium is important in management to reduce seizure risk and support overall stabilization. While other electrolyte disturbances can occur in people with alcohol use, they are not as characteristic of delirium tremens as hypomagnesemia.