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Imipramine in absence and myoclonic-astatic seizures

Departments of Neurology (Dr. Fromm and Dr. Van horn). Pediatrics (Dr. Wessel), and Pharmacology (Dr. Glass), University of Pittsburgh School of Medicine, and the Department of Pharmacology (Dr. Alvin), University of Pittsburgh School of Pharmacy.

A double-blind crossover study with imipramine was conducted in 10 patients with absence and myoclonic-astatic seizures who had not responded to conventional medications. Imipramine produced a significant initial decrease in seizure frequency in 5 of the 10 patients, and in 2 patients the beneficial effect was maintained for more than 1 year. An open trial of imipramine in another 16 patients showed an initial reduction in seizure frequency in 10 patients (63 percent), and this decrease persisted for more than 1 year in 4 patients (25 percent). The effect of imipramine on the EEG did not always correlate with the clinical response. Serum content of imipramine in the patients who showed a long-term response was 40 to 120 ng per milliliter, on a total daily dose of 0.7 to 3.5 mg per kilogram. These results suggest that imipramine is a valuable addition to the treatment of seizures.

This work was supported by a grant in aid from the Geigy Pharmaceuticals Division of the Ciba-Geigy Corporation.

Presented in part at the twenty-ninth annual meeting of the American Academy of Neurology, Atlanta, April 1977.

Reprint requests should be addressed to Dr. Fromm, Department of Neurology, University of Pittsburgh School of Medicine. 322 Scaife Hall. Pittsburgh, PA 15261.

Accepted for publication March 27, 1978.

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