Accidental tricyclic antidepressant poisoning in a 2 year-old boy

We present a 2-year old boy with accidental ingestion of a tricyclic antidepressant and outline the clinical features, management and prevention. Despite ingesting a high dose of amitriptyline (20mg/kg) and showing serum levels above the toxic range (1380 ng/ml), our patient did not develop any life threatening complications. Gastric lavage followed by instillation of activated charcoal, repeated at 6 hours, along with supportive measures led to complete recovery in 48 hours. As children are often exposed to tricyclic antidepressant poisoning, their carers and physicians need to be well aware of the disorder and its management.