Prescribing practices and knowledge of tricyclic antidepressants among physicians caring for children

We did not find any significant difference between pediatricians and family practitioners with regard to their knowledge of the potentially serious toxicities of the tricyclic antidepressants. One of this group, imipramine, is in widespread use for the treatment of enuresis. A large proportion of the pediatricians (40%) and family practitioners (50%) surveyed use this drug as the first or only approach to enuresis. It is disquieting to discover that, of those physicians choosing to use the drug, one third appear to be unaware of its toxic potential. Other effective treatment modes are available, and it is to be hoped that more physicians will explore them before turning to the more hazardous pharmacologic alternatives. Pediatricians, although not more knowledgeable than family practitioners, exhibited more careful prescribing practices.