Which withdrawal symptom is most characteristic of alcohol withdrawal?

• A. Seizures are the hallmark of alcohol withdrawal.
• B. Tremors (hand tremors) with autonomic signs and potential delirium tremens in severe cases.
• C. Insomnia with general anxiety.
• D. Euphoria and increased energy.

Answer: (B)

Alcohol withdrawal most clearly shows physical signs of autonomic hyperactivity along with tremors. The typical pattern starts with shaky hands and is accompanied by a racing heartbeat, sweating, and sometimes high blood pressure. This combination reflects the body’s reaction to suddenly stopping alcohol after regular use. In more severe cases, these signs can progress to delirium tremens, usually peaking a couple of days after the last drink, with confusion, severe agitation, fever, and hallucinations. Seizures can occur during withdrawal, but they are not the defining feature. Insomnia and anxiety are common but nonspecific, and euphoria with increased energy does not fit withdrawal at all.