To the Editor.—
Imipramine hydrochloride (Tofranil) has been widely used in the therapy of childhood enuresis.1,2 In 1960 Noack3 described the first pediatric patient with imipramine poisoning, and since that time others have reported toxic effects from this drug. Imipramine hydrochloride has a direct effect on the myocardium, and most complications are cardiotoxic in nature. These disturbances occur with "overdosage," and the only cardiovascular effect noted thus far in children with therapeutic dosages has been postural hypotension. Kristiansen noted specific electrocardiographic abnormalities in adults receiving therapeutic doses of imipramine hydrochloride for depression.4 These abnormalities include flattening or inversion of the T waves and occasionally ST segment depression. This report describes electrocardiographic monitoring of 14 patients receiving three dosage schedules of imipramine hydrochloride for treatment of enuresis.
Materials and Methods.—
Fourteen children, nine boys and five girls, aged 5 to 10 years were included in the study population.
Martin GI, Zaug PJ. ECG Monitoring of Enuretic Children Given Imipramine. JAMA. 1973;224(6):902–903. doi:10.1001/jama.1973.03220200058028
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