title: Neurologic and Cardiovascular Complications in Pediatric Life Threatening Imipramine Poisoning.
abstract: We present an 18-month boy with imipramine poisoning to illustrate the neuro-cardiac toxic effects of this potentially deadly poison in children. The toddler ingested an unknown amount of imipramine from a non-childproof bottle which clearly labelled that the drug must be kept out of reach from children. He developed neurologic and cardiac symptoms. Electrocardiography (ECG) showed tachycardia and widened QRS. He was immediately treated with bicarbonate infusion and made an uneventful recovery. This is the youngest and only reported case of symptomatic imipramine ingestion in our locality. Imipramine has been surpassed by newer antidepressants for the treatment of depression in the past decade. Literature is searched to review the mortality rate in young children. Intensive care neuro-cardiac support contributes to the favorable outcome. Despite clear labelling of the bottle, carelessness on the part of the adult and the use of non-childproof bottle are definite preventable factor to such potentially fatal ingestion.
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@hotmail.com.
authors.forename: Kam L
authors.initials: KL
authors.lastname: Hon
authors.forename: Ching K
authors.initials: CK
authors.lastname: Fung
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Lee
authors.forename: Kam L
authors.initials: KL
authors.lastname: Cheung
authors.forename: William
authors.initials: W
authors.lastname: Wong
authors.forename: Alexander K C
authors.initials: AK
authors.lastname: Leung
mesh_terms: D000061:Accidents, Home; D018759:Adrenergic Uptake Inhibitors / Q000506:poisoning*; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D062787:Drug Overdose; D004562:Electrocardiography; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007099:Imipramine / Q000506:poisoning*; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D013610:Tachycardia / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000929:Antidepressive Agents, Tricyclic; D017693:Sodium Bicarbonate; D007099:Imipramine