1 University of Arizona, School of Medicine, Tucson, Arizona 85712
2 Physicians Poison Control Service, University of Colorado Medical Center, Denver, Colorado 80220
3 Department of Pediatrics, University of Oklahoma Medical Center, 801 N. E. 13th Street, Oklahoma City, Oklahoma 73104
It was of interest to read that postural hypotension occurred in a patient in a "therapeutic dose" of imipramine.1 This, however, is common in patients on any of the tricyclic antidepressants (amitriptyline, nontriptyline, and so forth) as these drugs decrease the cardiovascular reflexes, such as carotid reflex, Bezold-janisch reflex, and postural reflexes.2,3
I take issue with the statement that the patient was on "therapeutic dosages of this drug," as she exhibited many of the toxic manifestations of this class of compounds.