Sudden death in children treated with a tricyclic antidepressant

Article Abstract:

Sudden death has occurred in at least three children who were receiving the tricyclic antidepressant desipramine, a metabolite of imipramine. Desipramine is available as Norpramin, Pertofrane, and generically. With the exception of imipramine (Tofranil and others) which has been approved for nighttime bedwetting, the FDA has not approved the use of tricyclic antidepressants in those under age 12 because they have not been extensively tested in children. Even so, both drugs have been used to treat childhood depression, and also attention deficit disorder (ADD) in those children who do not respond to such stimulant drugs as methylphenidate (Ritalin and others). Tricyclic antidepressants may cause conduction changes in the heart; they may prolong the PR interval, widen the QRS complex, invert or flatten the T-waves, or cause tachycardia or ventricular fibrillation. These affects are related to dosage and have occurred in adults who have taken either a deliberate or accidental overdose. But the way in which drugs act in the body may differ in children and adults and children may be more susceptible to drug adverse effects. The plasma levels of desipramine obtained from the three children who died were at or below therapeutic range. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Abnormalities, Causes of, Sudden death, Depression in children, Childhood depression, Heart conduction system, Antidepressants, Tricyclic, Tricyclic antidepressants, Desipramine, Norpramin (Medication), Pertofrane (Medication)

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Clonidine for treatment of attention-deficit/hyperactivity disorder

Article Abstract:

The safety of treating children with attention deficit/hyperactivity disorder (ADHD) with the antihypertensive drug clonidine (Catapres) may be questionable. Clonidine therapy in small groups was linked to improvements in the areas of motor tics and impulsive-hyperactive behavior, but had minimal impact on hyperactivity. Clonidine frequently causes irritability and sedation as well as hypotension and heart racing. Sudden discontinuation of clonidine brings on a resurgence of symptoms. In addition, five unexplained sudden deaths occurred in children who were taking clonidine.

Clonidine

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Another long-acting methylphenidate (Metadate CD)

Article Abstract:

An extended-release form of methylphenidate (Ritalin) is now available under the trade name Metadate CD. It can be taken once a day in the morning, but only lasts for about eight hours. It is used to treat attention deficit/hyperactivity disorder.

Product/Service Evaluation, Metadate (Medication)

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