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.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Toxic Tag this Diagnosis.

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	Sensitivity	Specificity	Comments, Study
ECG R/S Ratio	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	Sensitivity	Specificity	Comments, Study
Terminal QRS Axis	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	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	78%	56%	QTc > 430ms. for ventricular arrhythmias Study: J Toxicol Clin Toxicol. 2004;42(6):877-88. PMID: 15533027
Wide QRS	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