A 3-year-old with altered mental status presents after acting agitated. Which medication overdose is likely responsible for her symptoms?

The scenario describes a 3-year-old child with altered mental status and agitation, which raises suspicion for medication overdose as a potential cause. The correct answer points to tricyclic antidepressants (TCAs), which are known for their potential to cause significant effects on the central nervous system, especially in pediatric populations.

TCAs can lead to altered mental status, agitation, confusion, hallucinations, and even seizures. The agitation could stem from their anticholinergic properties, which can lead to symptoms such as delirium, while cardiotoxic effects may also present in overdose scenarios. Given the age of the child and the clinical presentation of altered mental status combined with agitation, TCAs are particularly indicated, as they are commonly implicated in pediatric poisoning cases.

In comparison, beta-blocker overdose typically presents with bradycardia and hypotension rather than altered mental status and agitation as primary symptoms. Antihistamines might cause sedation and confusion but are less likely to induce agitation as a prominent symptom, especially with overdose in a child. Barbiturate overdose can lead to central nervous system depression, resulting in lethargy or coma, but would be less associated with agitation. Therefore, the profile of TCA overdose aligns most closely with the symptoms presented in