Which drug class is used to treat agitation, muscle rigidity, seizures, and hypertension associated with MDMA overdose?

• A. Benzodiazepines
• B. Beta blockers
• C. Antipsychotics
• D. Opioids

Answer: (A)

Overdose from MDMA creates a hyperactive nervous system with sympathetic overdrive, leading to agitation, muscle rigidity, seizures, and high blood pressure. The best way to rapidly calm this state and prevent seizures is to use benzodiazepines. They enhance GABA, the brain’s main inhibitory neurotransmitter, producing sedation, anxiolysis, muscle relaxation, and anticonvulsant effects. This directly reduces CNS excitation and the accompanying autonomic spillover that drives hypertension and hyperactivity. Other options don’t address the CNS overactivity as effectively and can carry additional risks in MDMA toxicity: beta blockers may not safely control the sympathetic surge and can be problematic in stimulant overdoses; antipsychotics can worsen hyperthermia or cause extrapyramidal effects; opioids don’t treat the underlying agitation or seizures.