Cardiotoxic side effects associated with tricyclic antidepressant overdose

Tricyclic antidepressants (TCAs) are a popular, effective medication prescribed for patients with depression. The patient with severe depression may exhibit suicidal tendencies; thus, overdose of a prescribed TCA may occur, resulting in a potentially fatal outcome. The cardiotoxic effect of TCA overdose is the most pronounced complication. Multiple rhythm disturbances may occur in the presence of a TCA overdose. The greatest number of adverse cardiac symptoms and electrocardiographic changes are likely to occur within the first 24 hours after overdose. Nursing care of the patient with a TCA overdose is based upon ongoing patient assessment, identification of problems and potential problems, establishment of expected patient outcomes, and specific nursing interventions.