Benzylpiperazine (BZP) exposure is associated with which of the following effects?

• A. CNS depression with normal vitals, slurred speech, ataxia, and possible coma
• B. Hyperactivity with tremor and insomnia
• C. Severe agitation and hypertension
• D. Complete anesthesia without reflexes

Answer: (A)

BZP acts as a stimulant, but toxicity can progress to CNS depression when used in high doses or with depressants. The description of CNS depression with normal vitals, slurred speech, ataxia, and possible coma captures this severe end of the spectrum, where the brain’s function is suppressed rather than stimulated, and autonomic signs may not be prominent. This contrasts with the more typical stimulant picture of hyperactivity, tremor, and insomnia, or with severe agitation and hypertension. So, while BZP commonly produces stimulant effects, the noted presentation of CNS depression represents a possible, though less frequent, toxic outcome.