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Poorly Diagnostic Findings

Tricyclic Antidepressant Toxicity: Sensitivity and Specificity

Introduction: Overdose of tricyclic antidepressants can lead to a number of serious side effects, including cardiac arrhythmias (ventricular and blocks), seizures, and anticholinergic delirium.

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The sensitivity and specificity of findings for Tricyclic Antidepressant Toxicity are listed below. See the left navigation bar to change the display.

Specific Findings

Finding SensitivitySpecificity Comments, Study
ECG R/S Ratio Edit 47%97%

R/S ratio > 0.7 for ventricular arrhythmias

Study: J Toxicol Clin Toxicol. 2004;42(6):877-88. PMID: 15533027

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Terminal QRS Axis Edit 33%71%

Right axis deviation of 120-270 degrees in the terminal 40ms frontal plane QRS vector

for ventricular arrhythmias

Study: J Toxicol Clin Toxicol. 2004;42(6):877-88. PMID: 15533027

TCA Level Edit 78%57%

for ventricular arrhythmia. For seizures, Sens 75% Spec 72%

Study: J Toxicol Clin Toxicol. 2004;42(6):877-88. PMID: 15533027

Prolonged QTc Edit 78%56%

QTc > 430ms. for ventricular arrhythmias

Study: J Toxicol Clin Toxicol. 2004;42(6):877-88. PMID: 15533027

Wide QRS Edit 79%46%

QRS > 0.1 s

for ventricular arrhythmias. For seizures, Sens 69% and Spec 69%.

Study: J Toxicol Clin Toxicol. 2004;42(6):877-88. PMID: 15533027