Plasma Levels of Imipramine (IMI) and Desmethylimipramine (DMI) and Clinical Response in Prepubertal Major Depressive Disorder: A Preliminary Report

Puig-Antich, Joaquim; Perel, James M.; Lupatkin, William; Chambers, William J.; Shea, Catherine; Tabrizi, Mary Ann; Stiller, Richard L.

doi:10.1016/s0002-7138(09)62210-x

Cited by 106 publications

(16 citation statements)

References 16 publications

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“…An example of the latter would include the development of increased substance abuse, delinquency, and antisocial personality disorders among those who suffer both depressive and conduct disorders. Data are sparse regarding outcome questions; however, preliminary data on prepubertal male subjects with combined depressive and conduct disorder led investigators to comment that these boys had much more difficulty in their course of treatment than did purely depressed peers (Puig-Antich et al, 1979). Nine of the 13 required hospitalization in the course of their treatment.…”

Section: Comorbiditymentioning

confidence: 99%

Assessing severity in behavior disorders: Empirically based criteria

Clarizio

1990

Psychol. Schs.

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School psychologists are routinely required to make judgments about the severity of behavior disorders in children. While federal law demands that a child exhibit an emotional problem "to a marked degree," school psychologists are given few clearcut guidelines for making judgments about the severity of students' adjustment problems. The purpose of this paper is to present a list of empirically based criteria for assessing the severity of behavior disorders in children. To this end, research on major behavior disorders in children of interest to school psychologists is reviewed.School psychologists are routinely required to make judgments about the severity of behavior disorders in children. As used herein, the term behavior disorders refers to both conduct disorders and emotional problems. Severity refers to the degree or harmful extent of the consequences of given disorders. Not only would a very severe condition have adverse effects on the individual and/or others, it would also be characterized by a poorer response to intervention and have an unfavorable outcome. Given the ubiquity of children's problems and the financial constraints of school districts, care must be exercised in rendering judgments about the severity of children's person and social difficulties. Federal law (e.g., PL 94-142) requires that a child manifest an emotional problem "to a marked degree"; some state laws demand differentiation between seriously emotionally disturbed and emotionally disturbed; yet psychologists are given few clearcut guidelines for making judgments about the severity of students' adjustment difficulties.Major texts on child psychopathology (Quay & Werry, 1986) and school psychology (Reynolds & Gutkin, 1982) do not provide explicit, systematic, integrative coverage of this important issue. Thus, despite the ever-present demand to evaluate the severity of pupils' behavior disorders, psychologists are given very little precise guidance in making judgments about the severity of children's adjustment problems.The purpose of this article is to develop a list of empirically based criteria by which psychologists can judge the severity of behavior disorders in children. To this end, the published research literature on the major behavior disorders in children that is of interest to school psychologists is reviewed. The focus of this review is limited, by and large, to a discussion of the nature of the child's condition as it relates to severity. Discussion of home (e.g., parental psychopathology), community (e.g., community disorganization), and classroom factors (e.g., pacing) are excluded, even though they influence severity of the child's disorder. Moreover, no attempt has been made to review systematically each criterion presented with respect to every psychopathological disorder of childhood as described in the Diagnostic and Statistical Manual of Mental Disorders (DSM 111-R, 1987), which devotes 68 pages to disorders usually first evident in infancy, childhood, or adolescence (excluding mood disorders and schizophrenia, ...

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Section: Comorbiditymentioning

confidence: 99%

Assessing severity in behavior disorders: Empirically based criteria

Clarizio

1990

Psychol. Schs.

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“…Children metabolize and eliminate TCAs more efficiently than young adults and much more efficiently than geriatric patients (Geller et al, 1987;Jatlow, 1987;Preskorn et al, 1982Preskorn et al, , 1983Puig-Antich et al, 1979Teicher and Baldessarini, 1987;Weller et al, 1982;Wilens et al, 1992Wilens et al, , 1993. T o provide serum concentrations of TCAs similar to those considered therapeutic and safe in adults, weight-corrected daily doses (milligrams per kilogram) need to be considerably greater in pediatric patients (Wilens et al, 1992(Wilens et al, , 1993.…”

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confidence: 99%

Predicting Desipramine Levels in Children and Adolescents: A Naturalistic Clinical Study

Biederman

Faraone

Baldessarini

et al. 1997

Journal of the American Academy of Child & Adolescent Psych

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“…, 1987;Veith et al, 1982) or children (Biederman et aI. , 1985;Preskorn et aI., 1983;Puig-Antich et al, 1979 with normal baseline ECGs. In the absence of A-V conduction block, prolongation of PR interval usually is of no hemodynamic consequence.…”

mentioning

confidence: 99%

“…Nevertheless, occasionally there may be serious cardiovascular reactions to unusually high doses or tissue levels of TCAs in pediatric patients , as suggested by a report of the sudden death of a 6-year-old girl receiving a very high dose of imipramine , 15 mg/kg/d , described earlier (Saraf et aI., 1974). Although the reversibility of TCA-induced adverse cardiovascular effects in children has not been investigated systematically, clinical experience indicates that cardiovascular changes associated with imipramine and DMI are rapidly reversible with decreased or discontinued dose (Puig-Antich et al , 1979.…”

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confidence: 99%

“…Food and Drug Administration recommended ECG criteria considered unsafe in the use of imipramine in children (Puig-Antich et al, 1979 include the following: (1) PR interval > 200 ms; (2) QRS interval > 30% increased over baseline values (or > 120 ms); (3) blood pressure > 140 systolic or 90 diastolic (0/58); and (4) heart rate > 130 BPM at rest. Based on the experience at our center, we recommend that a DMI serum level below 300 ng/ml, ECG PR interval < 200 ms, and QRS duration < 120 ms appear to be more l.Am.…”

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confidence: 99%

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