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In this cases series, we present three patients who were unresponsive to escalating doses of standard delirium medications, but whose delirium resolved once improved sleep was achieved using Pentobarbital. In a fourth patient, delirium was successfully treated where neuroleptics were contraindicated. Pentobarbital has been shown to reduce the time to sleep onset, decrease the number of body movements during sleep and spontaneous awakenings and increase the total sleep time. Pentobarbital may provide an additional treatment option for patients whose delirium is refractory to standard management approaches.<\/jats:p>","DOI":"10.1177\/1049909112474111","type":"journal-article","created":{"date-parts":[[2013,1,23]],"date-time":"2013-01-23T21:02:28Z","timestamp":1358974948000},"page":"105-108","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Use of Pentobarbital in Cases of Severe Delirium"],"prefix":"10.1177","volume":"31","author":[{"given":"Christopher W.","family":"Kerr","sequence":"first","affiliation":[{"name":"Department of Research, Center for Hospice & Palliative Care, Cheektowaga, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra L.","family":"Luczkiewicz","sequence":"additional","affiliation":[{"name":"Department of Research, Center for Hospice & Palliative Care, Cheektowaga, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Holahan","sequence":"additional","affiliation":[{"name":"Department of Ethics, Humanities and Palliative Care, University of Rochester Medical Center, Rochester, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Milch","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Palliative Care, Veteran\u2019s Affairs Medical Center, Buffalo, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei C.","family":"Hang","sequence":"additional","affiliation":[{"name":"Department of Research, Center for Hospice & Palliative Care, Cheektowaga, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,1,22]]},"reference":[{"key":"bibr1-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.885"},{"key":"bibr2-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.43.3.183"},{"key":"bibr3-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.140.8.1048"},{"key":"bibr4-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.45.2.107"},{"key":"bibr5-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000901)89:5<1145::AID-CNCR24>3.0.CO;2-X"},{"key":"bibr6-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90011-6"},{"key":"bibr7-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1994.tb01747.x"},{"key":"bibr8-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.786"},{"issue":"2","key":"bibr9-1049909112474111","first-page":"CD005594","author":"Lonergan E","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr10-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1592\/phco.27.4.588"},{"key":"bibr11-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.2.281"},{"key":"bibr12-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000038351.32678.4A"},{"key":"bibr13-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1007\/3-540-33396-7_67"},{"key":"bibr14-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22057"},{"key":"bibr15-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1007\/BF00405022"},{"key":"bibr16-1049909112474111","doi-asserted-by":"publisher","DOI":"10.1007\/BF00401413"},{"key":"bibr17-1049909112474111","volume-title":"Insomnia: Principles and Management","author":"Szuba MP","year":"2003"},{"key":"bibr18-1049909112474111","unstructured":"Brunton L, Chabner BA, Knollmann B. 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