Tricyclic Antidepressant Toxicity Follow-up

Updated: Dec 12, 2017
  • Author: Vivian Tsai, MD, MPH, FACEP; Chief Editor: David Vearrier, MD, MPH  more...
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Further Inpatient Care

Level of consciousness and electrocardiographic (ECG) changes at presentation are the most sensitive clinical predictors of serious complications. Consider intensive care unit admission for any patient with ECG changes. Admission to a monitored bed is appropriate for patients exhibiting only anticholinergic symptoms and no cardiac manifestations.

Cyclic antidepressant (CA) toxicity typically lasts 24-48 hours following a significant overdose. However, studies have reported prolonged CA toxicity lasting as long as 4-5 days. [23] Amitriptyline is the drug most commonly implicated in these cases.