Linking the evidence to advance health equity among individuals with mental illness

T antidepressants (TCAs) are commonly used to treat a number of disorders, including neuropathic pain, major depressive disorder, obsessive-compulsive disorder and others. The development of new antidepressant medications have reduced the use of TCAs but the incidence of TCA overdose remains significant, representing the seventh leading cause of toxic exposures in 2008. This case presentation identifies not only classic presenting symptoms of TCA overdose but also commonly overlooked early signs and symptoms including early EKG changes. Review of initial presenting symptoms and laboratory/EKG findings aid in the early recognition of TCA overdose in the non-ER/EMT setting.