TL;DR Phenobarbital is a good alternative or adjunct for treatment of alcohol‌‌ withdrawal syndrome. It has particular benefits for patients with severe‌‌ alcohol withdrawal. High risk patients are those with prior seizure,‌‌ delirium tremens, ICU‌‌ admission, benzodiazepine infusion, or failure to respond to typical‌‌ treatments. Tread careful when patients