Imipramine

Pulmonary hypersensitivity The tricyclic antidepressant imipramine. is commonly associated with eosinophilia, sometimes extreme, and diarrhoea. It is not usually associated with pulmonary hypersensitivity. A 39-year-old woman, who had been taking imipramine for 4 weeks for depression was admitted with a I week history of productive cough (clear to white sputum), low grade fever, shortness of breath, headache, palpitations, blurred vision, urinary retention, diarrhoea and general malaise. WBC was 23,200/mm~ with 34% eosinophils. Arterial blood gases measured pH 7.41 Peal 36mm Hg. P01 60mm Hg and HCOJ 23mmolfL with the patient breathing oxygen. Chest x-ray showed a mixed interstitial and alveolar pattern. A diagnosis of pulmonary hypersensitivity was established. Imipramine was withdrawn, and IV methylprednisolone sodium succinate (60mg) administered. Two days later the chest x-ray showed marked improvement and eosinophils had decreased to 22%. The patient was later discharged on oral prednisone. Carlson. D.a and Healy. J.: Southern Medical Journal 75. 514 (Apr 1982.

6 Reactions 9 Jul 1982 0157 -7271/82/0709-0006/0$01.00/0 t: ADIS PresS