Reactions 1496, p25 - 12 Apr 2014

SImipramine

Interstitial lung disease in an elderly patient: casereport

A 75-year-old woman, who had a psychiatric disorder withsleep disturbances, developed interstitial lung disease duringtreatment with imipramine.

The woman, who had a history of a psychiatric disorder withsleep disturbances for the past 25 years, for which she hadbeen receiving imipramine 25 mg/day [route not stated],presented with a 15-day history of cough and dyspnoea[duration of treatment to reaction onset not stated]. Her coughwas associated with a moderate quantity of sputum but withno blood or bile staining. She was hospitalised and her vitalsigns were as follows: HR, 103/min; BP, 130/70 mmHg; andrespiratory rate, 34 cycles/min. Physical examination wasnormal apart from coarse inspiratory crepitations. Laboratorytests revealed the following: leucocytes, 11 200 cells/mm3

(eosinophils, 2.3%); erythrocyte sedimentation rate, 55 mm/h;and absolute eosinophil count, 300 cells/mm3. A chest x-rayshowed bilateral lower zone non-homogeneous opacity.Pulmonary function tests revealed a restrictive lung diseaseand, as per high-resolution CT scan and chest x-ray reports,she was diagnosed as having chronic interstitial lung disease.

Imipramine was suspected to be the cause due to thewoman’s long-term exposure to the drug and, on hospitalday 6, it was discontinued. As the disease was chronic, therewere no dramatic changes in her condition following thedrug’s withdrawal. She was discharged with oral corticosteroidtherapy and received routine treatment for the disease [patientoutcome not stated].

Author comment: "The adverse drug reaction (ADR) wasassessed by using the Naranjo scale and the Hartwig scale,and the ADR was found to be ’probable’ (Naranjo score 6)and ’moderate’ (level 4 [B], ie, the ADR was the reason foradmission), respectively."Deshpande PR, et al. Interstitial lung disease probably caused by imipramine.American Journal of Therapeutics 21: e66-e68, No. 2, 1 Apr 2014 -India 803101824

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Reactions 12 Apr 2014 No. 14960114-9954/14/1496-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved