A 2 1/2-year-old boy died as a result of cardiovascular complications of imipramine hydrochloride overdosage. Through a direct toxic effect on the myocardium, imipramine lowers myocardial contractility and cardiac output with resultant hypotension. Cardiac arrhythmias are also a constant feature of imipramine toxicity. Since there is no specific antidote to imipramine, treatment of over-dosage with this drug must be directed at its life-threatening circulatory and respiratory manifestations if the patient is to stand any chance for survival.
Sacks MH, Bonforte RJ, Lasser RP, Dimich I. Cardiovascular Complications of Imipramine Intoxication. JAMA. 1968;205(8):588-590. doi:10.1001/jama.1968.03140340058018