Possible teratogenicity of imipramine-chloropyramine

2784 cases of birth defects taken from the Finnish register of congenital malformations for 1964-72 and the same number of matched controls were reviewed to discover which mothers had used tricyclic antidepressants during pregnancy. Use of an imipramine/chloropyramine combination in the first trimester was associated with two craniofacial malformations and one centralnervous-system anomaly. In one case of malformation, amitriptyline had been taken in early pregnancy and in another case it had been taken during the third trimester. There was one amitriptyline user among the controls.