Iranian Heart Association Iranian Heart Journal 13 3 2012 09 01 ST ELEVATION IN TRICYCLIC ANTIDEPRESSANTS TOXICITY: A CASE REPORT 43 45 83244 EN Ali Taheriniya Assistant professor of emergency medicine,Alborz University of Medical Sciences, Karaj, Iran Azadeh Heidarpour General physician,Kermanshah University of Medical Sciences, Kermanshah, Iran Journal Article 2019 03 02 Of all antidepressants, tricyclic antidepressants (TCAs) are the most toxic drugs and they are often used for suicide attempts. An 18-year-old female was admitted to the emergency department after having taken 30 tablets of Nortriptyline 50 mg in a suicide attempt. A twelve-lead electrocardiogram revealed right bundle branch block in leads V<sub>1</sub>, V<sub>2</sub>, and V<sub>3</sub> as well as deep S in leads, V<sub>5</sub>, and V<sub>6</sub>, and tall R in AVR, which meant extreme right axis and ST elevation in leads V<sub>2</sub> and V<sub>3</sub>: that raised the suspicion of the Brugada syndrome. ST elevation after TCA toxicity is a rare medical condition, and our literature review failed to find any relevant reports. https://journal.iha.org.ir/article_83244_d153cf5d900b80f1e2dc7e61fd8b420d.pdf