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Pediatric cardiovascular effects of imipramine and desipramine

M G Bartels1, C K Varley, J Mitchell

  • 1Highline-West Seattle Mental Health Center, WA 98168.

Journal of the American Academy of Child and Adolescent Psychiatry
|January 1, 1991
PubMed

Insights

Imipramine and desipramine can slightly increase PR intervals in children and adolescents, with greater changes seen in those with baseline electrocardiogram abnormalities. No adverse clinical events were observed.

Area of Science:

  • Cardiology
  • Pediatric Pharmacology

Background:

  • Tricyclic antidepressants like imipramine and desipramine are used in pediatric populations.
  • Electrocardiogram (ECG) changes are potential side effects of these medications.

Purpose of the Study:

  • To evaluate the effects of imipramine and desipramine on electrocardiogram (ECG) parameters in children and adolescents.
  • To identify predictors of significant PR interval prolongation.

Main Methods:

  • Prospective evaluation of ECGs in 39 children and adolescents before and after treatment with imipramine or desipramine.
  • Analysis of PR interval changes and development of atrioventricular (AV) block.
  • Correlation of ECG changes with baseline ECG findings, medication, dose, and administration route.

Main Results:

  • Average PR interval increase of 0.01 seconds post-treatment.
  • 11 subjects showed a 0.02-second PR interval increase; 2 developed new first-degree AV block.
  • PR interval increase of ≥0.02 seconds correlated with pretreatment ECG abnormalities.
  • Subjects with abnormal baseline ECGs had a greater average PR interval increase (0.019s) compared to those with normal baseline ECGs (0.007s).

Conclusions:

  • Imipramine and desipramine can cause minor PR interval prolongation and occasional first-degree AV block in pediatric patients.
  • Preexisting ECG abnormalities may predict more significant PR interval prolongation.
  • Observed ECG changes were not linked to medication type, dose, or administration and did not lead to adverse clinical outcomes.

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