Phenobarbital in combination benzodiazepine administration compared to benzodiazepine-only Treatment (usual care) for Alcohol Withdrawal Syndrome in the Intensive Care Unit

Alcohol withdrawal can be a medical emergency, sometimes requiring admission to an intensive care unit (ICU). Standard treatment uses benzodiazepine medications, but these don't always work well enough for the most severe cases. This Phase 4 study is testing whether adding phenobarbital — an older but potentially more effective medication — to the standard treatment in the ICU can improve outcomes for critically ill patients withdrawing from alcohol. The study uses the hospital's electronic medical record system to identify eligible patients and guide the treatment. Participants will either receive phenobarbital plus standard care or standard care alone, with researchers tracking how quickly symptoms are controlled and whether any complications arise. This study is for adults aged 18 to 75 who have been admitted to the ICU and require treatment for alcohol withdrawal syndrome (defined by needing high doses of benzodiazepines). People with severe liver disease, certain drug interactions, allergies to phenobarbital, or who are pregnant are not eligible.