How are acute hallucinogen-induced anxiety or agitation typically managed?

• A. Benzodiazepines
• B. Antipsychotics
• C. SSRIs
• D. Mood stabilizers

Answer: (A)

Rapid relief of acute hallucinogen-induced anxiety or agitation comes from using a medication that quickly calms CNS arousal. Benzodiazepines are the first-line choice because they provide fast anxiolysis and sedation by enhancing GABAergic inhibition in the brain. This directly reduces agitation, agitation-related psychomotor overactivity, and sympathetic overdrive, and they also help decrease the risk of seizures in a situation where the brain is hyperexcitable. Clinically, agents like lorazepam are commonly used for this purpose because they act promptly and have predictable effects.

Other options aren’t as suitable for immediate stabilization. SSRIs and mood stabilizers take days to weeks to become effective and don’t address the acute distress. Antipsychotics can be helpful if there are prominent hallucinations or if agitation persists after benzodiazepines, but they carry risks such as extrapyramidal symptoms and other side effects, and they’re not the initial treatment for simple anxiety or agitation.