ECG-CHANGES IN PEDIATRIC-PATIENTS ON TRICYCLIC ANTIDEPRESSANTS, DESIPRAMINE, AND IMIPRAMINE

Objective: To determine if there is an altered pattern of cardiac elec trical activity in children treated with tricyclic antidepressants, de sipramine, or imipramine, which may predispose these patients to sudde n death. Methods: All patients in a child psychiatry practice from 198 9 to 1993 in Calgary, Alberta, treated with desipramine or imipramine with both pre- and post-treatment electrocardiograms (ECGs) were inclu ded in the study (n = 21; ages 8 to 17 years). Thirty-six blinded post -treatment ECGs were analysed for interval measurement and compared to the pretreatment ECGs. Results: Drug dosages ranged from 25 mg to 125 mg per day and treatment duration ranged from I to 49 months. Seven o f 21 patients were concurrently receiving an antipsychotic medication (pericyazine). The maximal increase in PR, and QRS, and QT interval ch anges were 40 msec and 70 msec, respectively, with most patients demon strating no significant changes in the ECG intervals. The QT interval was corrected for heart rate (QT(c)) No significant arrhythmias or tac hycardias were observed. ECG interval changes were not related to drug dosage, age, treatment duration or plasma levels. Conclusions: No con sistent pattern of ECG interval changes including the er, interval was observed in children on desipramine and imipramine.