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What is a hallmark sign of tricyclic antidepressant toxicity?

  1. Dysrhythmias

  2. Rash

  3. Drooling

  4. Hyperventilation

The correct answer is: Dysrhythmias

A hallmark sign of tricyclic antidepressant toxicity is the occurrence of dysrhythmias. Tricyclic antidepressants (TCAs) affect the cardiac conduction system, leading to potential arrhythmias. This is due to the sodium channel blockade that these medications can induce, which may result in prolonged QT intervals, bundle branch blocks, or even ventricular tachycardia. These dysrhythmias can be life-threatening and are one of the key concerns during the assessment and management of a patient suspected of TCA overdose. Other symptoms may present with TCA toxicity, such as CNS effects or anticholinergic symptoms, but dysrhythmias are specifically recognized as a classic and serious manifestation of this type of overdose. Recognizing this sign is crucial for timely intervention and can help guide treatment decisions to prevent more severe complications.