Acute Abdomen in a Child following Abrupt Withdrawal of Imipramine - A Case Report

Sir, Long term administration of psychotropic drugs produces significant biochemical changes, that often become manifest only after their withdrawal. Various clinical syndromes described are : rebound insomnia following benzodiazepene withdrawal (Kale et al., 1980), mania after imipramine withdrawal (Gupta et al., 1986) and hypomania following lithium withdrawal (Gupta, 1987). Such a process may be the result of shifts in the balance between intracellular production, synaptic reuptake and metabolic degradation of monoamines. There have been reports of gastrointestinal withdrawal symptoms like nausea, vomiting and abdominal discomfort with abrupt cessation of imipramine in children (Petti et al., 1981) and adults (Gupta, 1985). I present a case of nocturnal enuresis who developed acute abdomen following abrupt withdrawal of imipramine.