Imipramine in preschool autistic and schizophrenic children

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Imipramine was studied in 10 autistic and schizophrenic children 2 to 6 years of age, whose intellectual functioning ranged from low average and mild to severe mental retardation. The purpose of this pilot study was to explore the effects of imipramine in this patient population. Imipramine showed a mixture of stimulating, tranquilizing, and disorganizing effects. Three children improved markedly, 3 slightly, and 5 became worse (nonblind evaluations). Only 2 were rated improved by the “blind” psychiatrist. In general, this was not a good drug for this group of children. The overall effect was infrequently therapeutic and usually outweighed by the toxic effects. Epileptogenic effect, effect on psychosis, as well as possible mechanisms of action of imipramine are discussed. It is suggested that this drug merits further exploration in the most retarded, mute, anergic children, and in those with only borderline or little psychotic symptomatology.