Antidepressant and antipsychotic poisoning

Tricyclic antidepressants, citalopram, venlafaxine and monoamine oxidase inhibitors are the most toxic antidepressants in overdose. Features include hypotension and arrhythmias that are best managed by aggressive correction of metabolic acidosis with sodium bicarbonate. Antipsychotic drugs differ in their chemical structure and specificity at dopamine receptors. Overdose produces a range of adverse effects including sedation and acute extrapyramidal reactions. Cardiovascular effects including hypotension, prolongation of the QT interval and, potentially, arrhythmias including torsade de pointes are also seen.