What are the treatment options for a phencyclidine overdose?

Important: A suspected PCP (phencyclidine) overdose is a medical emergency. If someone is unconscious, having trouble breathing, seizing, dangerously overheated, or acting violently/confused, call 911 immediately. This article is for educationnot a substitute for medical care.

The short answer (for people who need it fast)

There is no “PCP antidote” that instantly reverses an overdose. Treatment is mostly supportive, symptom-focused emergency caremeaning clinicians stabilize breathing and circulation, calm dangerous agitation, control seizures, manage overheating, treat complications (like muscle breakdown), and watch closely until the drug’s effects wear off.

Core treatment options clinicians use

• Airway, breathing, circulation (ABCs): oxygen, IV access/fluids, monitoring; intubation/ventilation if needed.
• Calm environment + sedation: reduce stimulation; medications (often benzodiazepines) to control agitation, violence, and severe anxiety/psychosis.
• Seizure control: rapid treatment (commonly with benzodiazepines).
• Temperature control: cooling measures plus calming agitation that drives overheating.
• Testing + complication management: ECG, labs (kidney function, muscle breakdown markers), imaging if trauma is suspected.
• Decontamination (sometimes): activated charcoal may be used in select early oral ingestions when it’s safe to protect the airway.
• Observation or admission: monitored bed/ICU if severe symptoms or complications.
• Psychiatric and addiction follow-up: because PCP can trigger prolonged psychosis and long-term mental health issues.

First: what to do before professionals arrive (without becoming the second patient)

If you suspect PCP overdose, your #1 job is to get help and keep everyone safe. PCP intoxication can cause paranoia, aggression, and unpredictable strengthso “just calm down” usually doesn’t work (and can backfire spectacularly).

Do this

• Call 911 if the person collapses, can’t be awakened, has a seizure, is struggling to breathe, or seems dangerously overheated.
• Call Poison Control at 1-800-222-1222 for immediate, expert guidance (free and confidential in the U.S.).
• Keep distance and reduce stimulation: lower noise, dim lights, clear bystanders, remove dangerous objects.
• If they’re unconscious but breathing: place them on their side (recovery position) to reduce choking risk.
• Share what you know: tell responders what was taken (if known), when, and whether alcohol/other drugs might be involved.

Don’t do this

• Don’t try to “walk it off,” shower it off, or sweat it out. Overheating and agitation can get worse.
• Don’t restrain them yourself unless there is immediate danger and you are trainedstruggling can cause injury and may worsen muscle breakdown.
• Don’t argue, threaten, or crowd them. Keep your voice low, sentences short, and exits clear.

What happens in the ER: treatment options, step by step

Emergency teams treat PCP overdose like a high-stakes “choose-your-own-adventure,” except the goal is: everyone survives and nobody punches a monitor. Because symptoms vary widely, care is tailored to the person in front of the team.

1) Stabilization and continuous monitoring

Clinicians start with vital signs (temperature, heart rate, blood pressure, oxygen level) and a rapid exam. They monitor for complications such as irregular heart rhythms, respiratory failure, head injury, and severe agitation.

• Airway support: oxygen; if the person cannot protect their airway or is failing to breathe adequately, a breathing tube and ventilator may be needed.
• IV fluids: for dehydration, kidney protection, and to support blood pressure.
• Cardiac monitoring/ECG: to detect rhythm or conduction problems.

2) A calm room (yes, the lighting matters)

Reducing external stimulation is a real treatment tool. A quiet, dim environment can help lower agitation and decrease dangerous behaviors. Think “spa vibes,” not “nightclub strobe.”

3) Chemical sedation for agitation, violence, and severe anxiety

When someone is dangerously agitated, the priority is safetyfor the patient and for staff. The most common medication strategy is benzodiazepines (a class often used for severe agitation and seizures). They can decrease agitation and excess muscle activity, which also helps reduce overheating.

Physical restraints may be used in some cases, but many clinicians prefer to rely on medications + de-escalation whenever possible, because prolonged struggling can contribute to complications (like muscle injury).

4) Treating seizures quickly

Seizures can happen with severe PCP toxicity. In emergency care, benzodiazepines are commonly first-line to stop seizures and prevent recurrence. The team also checks blood sugar, electrolytes, and oxygenationbecause seizures are often worsened by correctable problems.

5) Managing high blood pressure and extreme overheating

PCP can drive dangerous increases in blood pressure and body temperatureoften because of intense agitation and muscle activity. Treatment typically focuses on:

• Calming agitation (often with benzodiazepines)
• Cooling measures for hyperthermia (removing excess clothing, cooling packs, cooled fluids when appropriate)
• Close monitoring for organ stress (heart, kidneys, brain)

If high blood pressure is severe or causing organ injury, clinicians may add additional medications based on the overall situation. (This is not DIY territorythese choices depend on the patient’s vitals, co-ingestions, and complications.)

6) Testing and imaging to look for hidden danger

PCP intoxication is notorious for two things: unpredictable behavior and injuries the person may not notice because pain perception can be altered.

Common ER evaluation can include:

• Blood and urine tests: kidney function, electrolytes, muscle injury markers, and screening for co-ingestions
• Urinalysis for myoglobin: to help detect muscle breakdown
• CT scan (sometimes): especially if trauma, severe confusion, or concern for head injury exists
• ECG: to assess the heart rhythm

One nuance: a urine drug screen can stay positive for PCP for a long time in chronic users, and false positives can occur with some medications. Clinicians interpret results alongside symptomsnot in isolation.

7) Activated charcoal (only in select cases)

If PCP was swallowed recently, clinicians may consider activated charcoalbut only when it’s medically appropriate and the airway is protected. In many cases, gastrointestinal decontamination isn’t needed, especially if the timeframe is unclear or the person is too sedated/agitated to safely swallow.

8) Observation, admission, and psychiatric evaluation

Some people improve quickly with supportive care. Others need prolonged observationespecially if they have:

• Persistent agitation or psychosis
• Seizures, hyperthermia, or severe hypertension
• Rhabdomyolysis (muscle breakdown) or kidney injury
• Traumatic injuries
• Suspicion of mixed overdose (PCP + alcohol/other drugs)

If medical complications resolve but severe behavioral symptoms remain, a psychiatric assessment may be needed. Recovery from a PCP-related psychotic state can take time, and follow-up planning matters.

Complications that change the treatment plan

Rhabdomyolysis (muscle breakdown)

Severe agitation, struggling, and overheating can injure muscle tissue. When muscle breaks down, it releases proteins that can damage the kidneys. Clinicians watch for this and treat with aggressive hydration and close kidney monitoring. Catching it early can prevent long-term damage.

Kidney injury or failure

Kidney injury may result from rhabdomyolysis, dehydration, or prolonged overheating. Treatment focuses on fluids, correcting electrolytes, and monitoring urine outputsometimes requiring higher-level care.

Trauma and aspiration

Falls, fights, and accidents are common in severe intoxication. If someone vomits while sedated or unconscious, they can aspirate (inhale stomach contents), which is why airway protection and positioning matter.

Prolonged psychosis or severe anxiety

Some individuals experience paranoia, hallucinations, or psychotic symptoms that outlast the initial intoxication. A low-stimulation environment, appropriate medications, and mental health follow-up can be essential.

What recovery and follow-up can look like

ER treatment is the “keep you alive” chapter. Recovery is the “keep you well” chapterand it deserves a plotline, not a footnote.

Medical follow-up

• Kidney checks if rhabdomyolysis occurred
• Neurologic follow-up if seizures occurred
• Mental health evaluation if paranoia, mood symptoms, or psychosis persist

Substance use treatment options

There isn’t a medication that “blocks” PCP in the way some medications help with other substance use disorders. But there are effective treatment approachesespecially behavioral therapies and structured programs.

• Assessment + referral: outpatient counseling, intensive outpatient programs, or inpatient/residential treatment depending on severity.
• Co-occurring care: treatment for anxiety, depression, trauma, or bipolar symptoms when present.
• Support resources: SAMHSA’s National Helpline (1-800-662-HELP) can connect people with treatment resources; local services are also accessible via 211 in many areas.

FAQ: quick answers people actually search for

Is there an antidote for PCP overdose?

No specific antidote exists. Treatment is supportive: stabilize vital functions and treat symptoms (agitation, seizures, overheating, complications).

How long do PCP overdose symptoms last?

It depends on dose, route, co-ingestions, and individual factors. Some effects fade within hours; severe agitation or psychosis may persist longer and needs medical monitoring.

Why do hospitals use a quiet, dim room?

Because overstimulation can worsen agitation and paranoia. Lower stimulation is a non-pharmacologic way to reduce risk and help sedation work better.

Can you “sleep it off” at home?

Not safely if there are severe symptoms. Overdose can involve seizures, dangerous overheating, breathing problems, injuries, and kidney damage. When in doubt, call 911 or Poison Control.

What if PCP was mixed with other substances?

Mixed overdoses are common and can increase riskespecially for breathing problems and heart complications. ER teams treat based on symptoms and may test for co-ingestions.

Experiences related to PCP overdose treatment (illustrative, composite examples)

Note: The following are realistic, anonymized “composite” experiences based on common emergency care patterns. They’re not real people, but the lessons are realand they’re the kind of details families wish they knew before an emergency happens.

Experience 1: “We thought it was just panicuntil the temperature kept climbing.”

A family member notices someone pacing, sweating, and talking fast, then suddenly becoming suspicious and combative. At first, it looks like a severe anxiety attack. But then the person’s skin feels unusually hot, they’re breathing rapidly, and they start bumping into things like their body is driving faster than their brain can steer. In the ER, the team prioritizes cooling and calming agitation because intense muscle activity can push body temperature dangerously high. The biggest surprise for the family: treatment isn’t about “flushing the drug out” with a magic detox. It’s about preventing the body from overheating and protecting the brain, heart, and kidneys while the drug wears off. The takeaway: if you see severe agitation plus signs of overheating, treat it like an emergency, not a mood swing.

Experience 2: “They didn’t complain of painso we assumed they weren’t injured.”

Another scenario: someone arrives confused after a night out, with a scraped shoulder and a limp, but they insist they’re fine and try to leave. PCP can alter pain perception and judgment, so “I’m okay” is not a reliable medical clearance. In the hospital, clinicians look for hidden traumasometimes ordering imaging if there’s concern for head injury or internal damage. The patient may be placed in a low-stimulation room and given medication to reduce agitation so the team can safely assess injuries. The takeaway: when a person is intoxicated, especially with dissociative drugs, the lack of pain complaints doesn’t rule out serious injuries.

Experience 3: “The urine test confused everyoneand the doctors kept saying ‘we treat the symptoms.’”

Families often expect one definitive test to explain everything. In real life, clinicians use tests as clues, not verdicts. PCP screens can be complicatedchronic use may lead to positives long after the last use, and false positives can happen with certain medications. Meanwhile, the person in the bed is sweating, hypertensive, and hallucinating right now. So the team focuses on what matters most: stabilizing breathing, calming agitation, treating seizures if they occur, and checking labs for muscle breakdown and kidney injury. The takeaway: in overdose care, the person’s vital signs and symptoms guide treatment more than a single lab result.

Experience 4: “The ER visit ended, but the recovery didn’t.”

One of the hardest experiences families describe is the “after.” Even when vital signs normalize, someone may remain paranoid, depressed, or cognitively foggy. Some people need psychiatric evaluation once the immediate intoxication passes, and others benefit from substance use treatment referralespecially if PCP use is recurring or connected to underlying mental health struggles. Families are often relieved to hear there are concrete next steps: follow-up for kidney function if rhabdomyolysis was suspected, mental health care if psychotic symptoms persist, and treatment resources (helplines and locators) to reduce the chance of another emergency. The takeaway: the best overdose treatment plan includes a handoffER stabilization plus a realistic recovery plan.

Conclusion

So, what are the treatment options for a phencyclidine overdose? In practice, they’re a focused set of emergency priorities: stabilize the airway and vitals, calm dangerous agitation, control seizures, manage hyperthermia, and treat complications like rhabdomyolysis, kidney injury, or trauma. Because there’s no single reversal agent, the “best” treatment is the one that matches the person’s symptomsfast.

If you’re ever unsure, don’t debate it like it’s a group chat. Call 911 for severe symptoms, and use Poison Control (1-800-222-1222) for immediate guidance. And once the crisis passes, consider follow-up supportbecause preventing the next emergency is also a form of treatment.