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Neurologic and Cardiovascular Complications in Pediatric Life Threatening Imipramine Poisoning

Kam L Hon1, Ching K Fung, Vivian W Lee

  • 1Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@hotmail.com.

Current Drug Safety
|July 30, 2015
PubMed

Insights

This case highlights severe neuro-cardiac toxicity from imipramine poisoning in an 18-month-old child. Prompt treatment with bicarbonate infusion led to a full recovery, emphasizing preventable ingestion factors.

Area of Science:

  • Pediatric Toxicology
  • Cardiology
  • Neurology

Background:

  • Imipramine, a tricyclic antidepressant, can cause severe neuro-cardiac toxicity in children.
  • Accidental ingestion in young children remains a significant concern despite clear labeling.

Observation:

  • An 18-month-old boy ingested an unknown quantity of imipramine from a non-childproof container.
  • The child presented with neurological and cardiac manifestations, including tachycardia and widened QRS on ECG.

Findings:

  • This case represents the youngest documented symptomatic imipramine ingestion in the region.
  • Intensive neuro-cardiac support, including bicarbonate infusion, was crucial for the patient's recovery.

Implications:

  • Accidental imipramine poisoning in young children can be fatal, necessitating prompt medical intervention.
  • Preventable factors include adult carelessness and the use of non-childproof packaging, emphasizing the importance of child safety measures.

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