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May 20, 1974

Imipramine for Nightmares

Author Affiliations

Mid-Fairfield Child Guidance Center Norwalk, Conn

JAMA. 1974;228(8):978. doi:10.1001/jama.1974.03230330020011

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To the Editor.—  In connection with the question by Dr. Leo Sell and the answer by Dr. Anthony Kales (227:1066, 1974), I would like to draw your attention to clinical observations we have made in a study of 12 sleepwalking and pavor nocturnus children. We used 25 to 50 mg of imipramine before bedtime with great success. From the psychotherapeutic point of view, although imipramine does not modify the personality structure, it does alleviate the symptoms and brings a certain degree of relaxation and well-being that is therapeutic in itself. It is of interest to note that even enuretic children who did not respond to imipramine therapy as far as their bed-wetting was concerned, were helped in alleviating pavor nocturnus or nightmares. There was no substitution of symptoms, regardless of whether the child was in psychotherapy or only seen in follow-up.At present, our procedure is as follows: We start