Tricyclic antidepressants (TCAs) are a type of medication commonly used to treat depression. However, if taken in excess or misused, they can lead to poisoning, which can have severe and potentially life-threatening consequences. TCA poisoning can cause a range of symptoms, including profound neurologic and cardiovascular manifestations. It is essential to seek medical attention immediately if TCA poisoning is suspected, as prompt treatment can significantly improve outcomes. The standard treatment for TCA poisoning involves administering sodium bicarbonate, which can help alleviate symptoms and prevent further complications. In a recent case, a 16-year-old girl was diagnosed with nortriptyline poisoning, a type of TCA. She presented with severe neurologic and cardiovascular symptoms, which required aggressive treatment. The medical team successfully treated her using a combination of sodium bicarbonate, intralipid emulsion, and plasmapheresis. The use of plasmapheresis, a procedure that involves filtering the blood to remove toxic substances, was particularly notable in this case. Plasmapheresis may be a valuable treatment option for patients with TCA poisoning who do not respond well to traditional treatments, such as sodium bicarbonate. This case highlights the importance of considering alternative treatment modalities, like plasmapheresis, in cases of severe TCA poisoning. By exploring new treatment approaches, medical professionals can improve patient outcomes and reduce the risk of fatal complications associated with TCA poisoning. Link: https://pubmed.ncbi.nlm.nih.gov/40148818/