• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1232-1235
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• 2008

Imipramine, a tricyclic antidepressant (TCA), is used for the treatment of non-polar depression and nocturnal enuresis in children in whom an organic pathology has been excluded, anxiety disorders, and neuropathic pain. Clinical toxicity following the treatment of TCAs, including imipramine, is well known. The anticholinergic effects initially present include a dry mouth, ileus, dilated pupils, urinary retention, and mild sinus tachycardia. The central nervous system toxicity includes delirium, agitation, restlessness, hallucinations, convulsions, and CNS depression or coma. However, the most life-threatening toxicity remains the development of cardiac dysrhythmias. Conduction delays such as QRS and corrected QT prolongation, wide QRS complex tachycardia, and the Brugada electrocardiographic pattern have been reported. Sodium bicarbonate decreases QRS widening and suppresses dysrhythmias by providing excess sodium to reverse the TCA-induced sodium-channel blockade and possibly by binding directly to the myocardium. There are no pediatric case reports on imipramine or other TCA associated toxicity in Korea. Here, we describe a patient who presented with convulsions, tachycardia with a wide QRS complex, a Brugada electrocardiographic pattern, and anuresis associated with an accidental overdose of imipramine and the outcome of treatment with sodium bicarbonate.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.93-101
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• 1994

This study was performed to assess the amount of altered serotonergic responsivity in individuals with repeated aggressive behaviors compared with normal controls. Sixteen aggressive(delinquent criminals with repeated aggressive behaviors) and seventeen controls(medical college students) were selected and assessed their severity of aggression by several psychological instruments. The platelet $^3H$-imipramine binding sites which is known to correlate the serotonergic function of the central nervous system were measured. The results are as follows. 1) Mean scores of physical aggression in the aggressive subjects were found to be significantly higher than normal controls(p<.01). And impulsivity, hostility, psychoticism in the aggressives were found higher than controls, also. 2) In the paltelet $^3H$-imipramine binding, the aggressives had a tendency of reduced maximal binding sites(Bmax) comparing with controls(p=.0841). 3) There was no statistically significant differences between two groups in the binding coefficients(Kd) of platelet $^3H$ Imipramine binding. 4) The value of maximal binding sites(Bmax) showed significant inverse correlations with aggressive scale scores of PFAV(r=-.6311), and physical aggression scale scores of CTS(r=-.5377).

• Korean Journal of Biological Psychiatry
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• v.5 no.1
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• pp.134-137
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• 1998

Authors report a case of separation anxiety disorder, which developed as a side effect during haloperidol treatment of Tourette syndrome(TS). In this case, 14 years old boy developed attention deficit symptoms during his infancy. At 4th grade of primary school, he developed vocal tic, motor tic, and coprolalia. With 5mg/day of haloperidol treatment his symptoms of TS were subsided. During the treatment, he developed features of separation anxiety disorder, including dependence, pleading, clinging, and sadness. Symptoms of attention deficit and separation anxiety disorder were improved by 25mg/day of imipramine treatment. During haloperidol treatment of TS, careful observation may be needed whether separation anxiety disorder-like symptom develops.

• Korean Journal of Biological Psychiatry
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• v.6 no.1
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• pp.74-80
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• 1999

This study was performed to investigate the mechanism of the clozapine-induced seizures in partially restrained rats by concomitant treatment with drugs affecting monoaminergic systems. Partially restrained rats treated with acute single doses of 10mg/kg clozapine exhibited myoclonic jerks (MJs). Drugs affecting the monoaminergic systems, including 2mg/kg haloperidol, 5mg/kg propranolol, 2mg/kg ritanserin, 20mg/kg fluoxetine, and 20mg/kg imipramine, were concomitantly treated with clozapine to observe the effects of these drugs on the MJs. The drugs were given intraperitoneally either as acute single doses(haloperidol, propranolol, ritanserin, and fluoxetine) or as chronic doses for 21days(haloperidol, imipramine, ritanserin, and fluoxetine). The effects of the concomitant treatment of other drugs on the clozapine-induced MJs were evaluated by comparison of the total numbers of the MJs between the clozapine-treated and concomitantly treated groups. The results were as follows. 1) Concomitant treatment with acute single doses of haloperidol, propranolol, and fluoxetine reduced the total numbers of the clozapine-induced MJs, while concomitant treatment with ritanserin did not. 2) Concomitant treatment with chronic doses of imipramine and ritanserin increased the total numbers of the MJs, while concomitant treatment with fluoxetine reduced them. Concomitant chronic treatment with haloperidol did not affect the numbers of the MJs. These results suggest that dopamine and serotonin, not noradrenalin may be involved in the clozapine-induced MJs in partially restrained rats. Future research needs to study the function of each subtype of monoaminergic receptors on the mechanism of the clozapine-induced seizure.

• Childhood Kidney Diseases
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• v.12 no.1
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• pp.78-87
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• 2008

Purpose: Recently, the conception and cognition that enuresis was resolved spontaneously, have changed. We reviewed the attitudes of the primary care physicians who make diagnose and treat nocturnal enuresis. Methods: From January 2006 to February 2007, a total of 293 primary care physicians in Daegu city participated in this survey. Questionnaires included questions about physicians' opinions on the appropriated age for diagnosis of enuresis, the likely causes of enuresis, etc. Physicians are grouped in two according to whether enuresis is major field of their subspecialty; the pediatrician & urologist group and the other physician group. Results: 59.2% of pediatricians and urologists thought that enuresis is defined as the nightly involuntary release of urine by children of the age of 5 to 6, while 49.6% of other physicians did. For the causes of enuresis, most of clinicians checked "yes" to the question that "Under-developed bladder and nerve" and "Emotional problems". In the patient's behavioral reactions related to enuresis, "Lack of concentration in home and school" and "Frequent urination" were most responded. Attendance to the education program of enuresis in last five years and willing to participate in education program was statistically different among pediatricians-urologists and other physicians. Regarding the treatment of enuresis, most physicians used imiprarnin widely, but pediatricians and urologists preferred desmopressin. Alarm was the last one in treatment modality. Conclusion: This study revealed that pediatricians and urologists are attending more to the educational places and knowing much about the recent information on enuresis when compared to other primary care physicians, regarding the diagnostic age and treatment modality of enuresis. The education of enuresis for primary physicians is more needed.