Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study.

Abstract

OBJECTIVE:

Pediatric burn patients often exhibit acute stress disorder (ASD) symptoms. Information on psychopharmacological treatment of ASD symptoms in children is scarce. This pilot study used a prospective, randomized, double-blind design to test whether thermally injured children suffering ASD symptoms benefit from imipramine.

METHOD:

Twenty-five children, aged 2 to 19 years, received either imipramine or chloral hydrate for 7 days. A structured interview (clinically useful, but validity and reliability not yet established) was used to assess the presence and frequency of ASD symptoms both before treatment and 3 times during the treatment period.

RESULTS:

Eleven females and 14 males participated, with a mean total burn surface area of 45% (SD = 23%) and mean age of 8 years (SD = 6). Imipramine was more effective than chloral hydrate in treating ASD symptoms (chi 2 [1, N = 25] = 5.24, p < .02). Five of 13 were positive responders to chloral hydrate (38%). Ten of 12 were positive responders to low-dose imipramine (83%).

CONCLUSIONS:

This pilot study suggests a place for cautious initial use of imipramine to reduce ASD symptoms in burned children. Care must be taken to minimize cardiovascular risks in an off-label application of imipramine in children, especially those receiving additional medications.

• Authors: R Robert, P E Blakeney, C Villarreal, L Rosenberg, W J Meyer 3rd
• Journal: Journal of the American Academy of Child and Adolescent Psychiatry (J Am Acad Child Adolesc Psychiatry) Vol. 38 Issue 7 Pg. 873-82 (Jul 1999) ISSN: 0890-8567 [Print] United States
• PMID: 10405506 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Placebos
• Chloral Hydrate
• Imipramine

Topics

• Acute Disease
• Adolescent
• Adult
• Burn Units (statistics & numerical data)
• Burns (complications)
• Chi-Square Distribution
• Child
• Child, Preschool
• Chloral Hydrate (therapeutic use)
• Female
• Humans
• Imipramine (therapeutic use)
• Male
• Pilot Projects
• Placebos
• Stress Disorders, Post-Traumatic (drug therapy, etiology)
• Texas