The goal of this clinical trial is to test whether the medication phenobarbital is as effective for treating agitated delirium among adult patients admitted to the intensive care unit. Agitated delirium is a condition involving confusion and impulsiveness which is dangerous to both patients and healthcare providers.

The main questions this trial aims to answer include:

• Can phenobarbital decrease the amount of time patients with agitated delirium spend in the intensive care unit and the hospital?
• Does phenobarbital decrease the amount of additional calming medications patients with agitated delirium need?

Researchers in this study will compare phenobarbital to other medications commonly used to treat agitated delirium.

Participants will be monitored closely to make sure they remain safe and to measure how well their agitation and confusion are managed while they are in the ICU.

Inclusion Criteria:

• Adult Patients identified by providers to have agitated or hyperactive delirium

Exclusion Criteria:

• Pregnancy
• Incarceration
• Severe liver disease
• Allergy or prior adverse reaction to phenobarbital or antipsychotic drugs (depending on the month of therapy initiation)

Only data pertaining to the primary and secondary objectives (e.g., hospital length of stay, doses of specific medications given, RASS assessments) will be shared. All data will be anonymized.

Following completion of the study (Estimated late 2027), for 1 year.

Only researchers who request IPD data and are approved by the DUH IRB to access will be permitted to review IPD data.