A 31-year-old man is brought to the emergency department by the police due to severe agitation, aggressive behavior, and paranoid delusions. He was found shouting at pedestrians, claiming that a secret agency is tracking him. His roommate reports he has been awake for three days and was seen snorting a white powder and drinking alcohol heavily earlier today. His medical history is unknown. He appears restless, diaphoretic, and hypervigilant. He is afebrile. His blood pressure is 165/100 mmHg with a heart rate of 125 bpm and a respiratory rate of 22 breaths per minute.