Cardiac toxicity in an adolescent following chronic lithium and imipramine therapy.
A case report is presented of an adolescent male who developed hypothyroidism and cardiomyopathy 6 months after he began taking lithium and imipramine for a severe conduct disorder. After discontinuation of psychiatric medications and institution of thyroid hormone replacement therapy, he developed asymptomatic but potentially serious dysrhythmias. Evidence for potential cardiac toxicity of combined lithium and tricyclic antidepressant therapy is reviewed. Repeated assessment of cardiac function during such therapy is advised.
Dietrich
A
A
Division of Emergency Medicine, Ohio State University, Columbus.
Mortensen
M E
ME
Wheller
J
J
D000293:Adolescent; D005117:Cardiac Complexes, Premature / Q000139:chemically induced; D009202:Cardiomyopathies / Q000139:chemically induced*; D002648:Child; D002653:Child Behavior Disorders / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D006333:Heart Failure / Q000139:chemically induced; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced; D007099:Imipramine / Q000008:administration & dosage / Q000009:adverse effects*; D008094:Lithium / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D013974:Thyroxine / Q000008:administration & dosage / Q000009:adverse effects; D016277:Ventricular Function, Left / Q000187:drug effects
D008094:Lithium; D007099:Imipramine; D013974:Thyroxine