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June 2, 1978

Cardiovascular Effects of Tricyclics for Enuresis

Author Affiliations

Covina, Calif

JAMA. 1978;239(22):2338. doi:10.1001/jama.1978.03280490022004

To the Editor.—  I read the article entitled "Cardiovascular Effects of Tricyclic and Tetracyclic Antidepressants" by Burckhardt et al (239:213, 1978).The authors mention that children are at increased risk for cardiotoxic reaction from tricyclic antidepressants. In a study with 27 children receiving therapeutic doses of imipramine for enuresis, we1 demonstrated no substantial ECG alterations. However, the therapeutic range is narrow, and as a dosage schedule of 4 to 5 mg/kg/day is reached, great abnormalities are noticed. Therefore, all children receiving this medication should have a normal ECG before therapy is started.