A naturalistic study of 24-hour electrocardiographic recordings and echocardiographic findings in children and adolescents treated with desipramine.

Full Abstract

OBJECTIVE: Recent studies assessing cardiovascular effects of desipramine (DMI) in pediatric patients consistently have found small, clinically benign, but statistically significant, increases in heart rate and electrocardiographic (ECG) conduction parameters. However, single, routine ECG recordings cannot fully assess potential infrequent rhythm disturbances. METHOD: We analyzed data from 24-hour ECG monitoring, two-dimensional Doppler echocardiography, and expert clinical cardiac examination of DMI-treated patients. Subjects were 71 children (N = 35) and adolescents (N = 36) receiving long-term treatment (means +/- SD = 1.5 +/- 1.2 years, median = 1.0 year) with DMI (means +/- SD = 3.5 +/- 1.6 mg/kg). RESULTS: Compared with previous observations in untreated healthy children. DMI-treated patients had significantly lower rates of sinus pauses and junctional rhythm, but significantly higher rates of single or paired premature atrial contractions and runs of supraventricular tachycardia. There was an association between DMI serum levels and paired premature atrial contractions, but no other associations were detected. CONCLUSIONS: These findings support the impression from previous ECG studies that DMI-associated cardiac effects in pediatric patients are quite benign. Nevertheless, it remains to be ascertained whether even minor cardiac abnormalities may predict later, evidently rare, adverse cardiovascular effects that may include sudden death.

Author information

Author/s: Biederman, J (J); Baldessarini, R J (RJ); Goldblatt, A (A); Lapey, K A (KA); Doyle, A (A); Hesslein, P S (PS);

Affiliation: Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.

Grants: NIMH MH-31154 (Agency:NIMH NIH HHS) ; NIMH R01 MH-41314-01A2 (Agency:NIMH NIH HHS) ; NIMH-47370 (Agency:NIMH NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, P.H.S.

Journal: Journal of the American Academy of Child and Adolescent Psychiatry (J Am Acad Child Adolesc Psychiatry), published in UNITED STATES. (Language: eng)

Reference: 1993-Jul; vol 32 (issue 4) : pp 805-13

Dates: Created 1993/08/27; Completed 1993/08/27; Revised 2007/11/15;

PMID: 8340302, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Am Acad Child Adolesc Psychiatry. 1995 Feb;34(2):125-6. (PMID: 7534755)

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