High dose amitriptyline poisoning is very important condition among emergency department visits. Particularly more than one gram of amitriptilin exposure may cause mortality. Most of the deaths occur in several hours after taking amitripitilin. Twenty three year old woman patient applied our emergency department with a complaint of unconsciousness after three grams amitriptyline exposure. At the inital approach of the patient, it was seen that cardiopulmoner collaps and myoclonic seizure had been developed. At her blood gas analysis, there was profound metabolic asidosis. Endotracheal entubation and antiepileptic drugs were applied to the patient. Also bicarbonate was given for her profound metabolic asidosis. Because of the patient’s acidosis did not improve with conservative treatment, hemoperfusion was applied to her. After two days follow up at intensive care unit, the patient recovered completely. As a conclusion, high dose amytriptilline poisoning is a serious case for emergency departments and can be fatal but appropriate evaluation and management of these cases at the emergency department can make patients recover rapidly.