Toxic desipramine ingestion is reviewed in light of the growing use of desipramine in children & adolescents. The case of a 14-year-old boy who took an overdose of desipramine & imiprmine in an attempt to kill himself is presented. The case is discussed in the context of adverse cardiovascular & central nervous system effects & deficiencies in the provision of care that increase the risk of self-endangering behavior.