It is vital to bring down the temperature of the patient who has ingested 3,4-methylenedioxymethamphetamine (MDMA, or Ecstasy). The nurse places ice packs over the axillae and groin and spritzes the patient with water with a fan blowing over the patient for cooling by evaporation. An intravenous benzodiazepine such as midazolam is used to control shivering, which will increase the patient’s temperature and metabolic demand. The patient is at risk for seizures both due to hyperthermia and to the hyponatremia associated with MDMA toxicity. Antipyretics, such as acetaminophen per rectum, are ineffective for MDMA-induced hyperthermia.