Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: A pilot study

Rhonda Robert, Patricia E. Blakeney, Cynthia Villarreal, Laura Rosenberg, Walter J. Meyer

Research output: Contribution to journalArticlepeer-review

124 Scopus citations


Objective: Pediatric burn patients often exhibit acute stress disorder (ASD) symptoms. Information on psychopharmacological treatment of ASD symptoms in children is scarce. This pilot study used a prospective, randomized, double-blind design to test whether thermally injured children suffering ASD symptoms benefit from imipramine. Method: Twenty-five children, aged 2 to 19 years, received either imipramine or chloral hydrate for 7 days. A structured interview (clinically useful, but validity and reliability not yet established) was used to assess the presence and frequency of ASD symptoms both before treatment and 3 times during the treatment period. Results: Eleven females and 14 males participated, with a mean total burn surface area of 45% (SD = 23%) and mean age of 8 years (SD = 6). Imipramine was more effective than chloral hydrate in treating ASD symptoms (χ2 [1, N = 25] = 5.24, p < .02). Five of 13 were positive responders to chloral hydrate (38%). Ten of 12 were positive responders to low-dose imipramine (83%). Conclusions: This pilot study suggests a place for cautious initial use of imipramine to reduce ASD symptoms in burned children. Care must be taken to minimize cardiovascular risks in an off-label application of imipramine in children, especially those receiving additional medications.

Original languageEnglish (US)
Pages (from-to)873-882
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number7
StatePublished - 1999
Externally publishedYes


  • Acute stress disorder
  • Imipramine
  • Medication therapy
  • Pharmacotherapy
  • Posttraumatic stress disorder

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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