Management of Massive Imipramine Overdosage with Mannitol and Artificial Dialysis

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Abstract
IMIPRAMINE hydrochloride (Tofranil), the chemical analogue of promazine in the phenothiazine series, has the chemical formula of 5-(3-dimethyl-aminopropyl)-10,ll, dihydro-5H-dibenz (b, f) azepine hydrochloride and has been widely used1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 in the management of depression since its introduction in clinical trials by Kuhn3 in 1957. Side reactions include thirst, dryness of the mouth, hypotension, urinary retention, constipation and other anticholinergic effects.6 Cases of massive overdosage are recorded,8 9 10 11 12 13 14 15 and in doses over 1200 mg., certain common features are seen: deep coma; hypotension; myoclonic seizures; and defects in cardiac conduction.10 Previous papers8 , 9 , 12 have reported recovery after ingestion of as much as 1500 to 2500 . . .

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