Abnormal ventricular repolarization mimicking myocardial infarction after heterocyclic antidepressant overdose

It is well known that antidepressant drugs, especially heterocyclic drugs, may have cardiovascular effects at therapeutic doses, influencing primarily arrhythmogenesis and electrical excitation and conduction.(1) The massive intake of these drugs for suicidal purposes can induce evident cardiac electrical alterations,(1-3) even in young adults without cardiac illnesses. Among these electrical alterations, no aspects of ventricular repolarization mimicking abnormal myocardial current of injury have been reported. We observed these alterations in 2 young adult women, who attempted suicide by taking an overdose of maprotiline? perphenazine plus benzodiazepine and amitriptyline plus benzodiazepines, respectively.