Imipramine belongs to a class of antidepressant drugs known as TCAs used to treat depression. According to the American Council for Headache Education, TCA-type antidepressants are thought to be effective, especially for people who have both migraine and depression. In general, the doses of TCA antidepressants, such as imipramine, tend to be lower than those needed to treat depression. Therefore, the side effects associated with this drug may be less noticeable, including upset stomach, drowsiness, weakness or tiredness, excitement, anxiety, difficulty sleeping, nightmares, dry mouth, skin sensitivity to sunlight, and changes in appetite or weight.

Depression, childhood bedwetting (enuresis).

Attention deficit hyperactivity disorder (ADHD), bulimia, chronic fatigue syndrome, chronic nausea and vomiting, diabetic neuropathy, irritable bowel syndrome (IBS), migraine prevention, mixed incontinence, multiple sclerosis, nocturia, panic disorder, post-traumatic stress disorder (PTSD), retrograde ejaculation, stress incontinence, urge incontinence.

Dry mouth, sedation, dizziness, headache, nervousness, skin rash, tremors, hives, nausea, constipation, vision changes, sweating, lowered blood pressure, increased heart rate, decreased sodium levels, suicidal ideation, changes in heart rhythm and conduction, blurred vision, weight gain, sexual dysfunction.

  • Do not use if you have been taking an MAO inhibitor (such as phenelzine, tranylcypromine, isocarboxazid) within the past 14 days. When used with MAO-Is fever, high blood pressure, increased heart rate, confusion, seizures, and deaths have been reported.
  • Not for use immediately after a heart attack.
  • Can cause sedation which may impair performance of tasks requiring alertness. Sedative effects may be additive with other drugs that cause similar effects (central nervous system depressants).
  • May worsen psychosis or mania in patients with bipolar disease.
  • Stop therapy with doctor permission and according to instructions (gradual taper) prior to elective surgery.
  • Do not abruptly stop medication; taper gradually.
  • Notify your doctor if you have low blood pressure as this drug can cause low blood pressure episodes.
  • Use with caution if you have urinary retention, history of cardiac disease, seizure disorders, diabetes, benign prostatic hyperplasia, narrow angle glaucoma, dry mouth, visual problems, constipation, or a history of bowel obstruction.
  • Possibility of suicide attempt may persist until remission occurs.
  • Use with caution in hyperthyroid patients or those receiving thyroid supplementation.
  • Use with caution if you have liver or kidney dysfunction or are elderly.
Avoid combination
  • MAOIs: Serotonin syndrome, some fatal.
Use only under specific circumstances
  • Bethanidine, clonidine: Inhibition of antihypertensive effect, possible hypertensive crisis.
  • Epinephrine, norepinephrine: Hypertension and dysrhythmias.
  • Moclobemide: Risk serotonin syndrome.
Minimize risk
  • Altretamine: Orthostatic hypotension.
  • Amphetamines: Theoretical increase in amphetamine effect.
  • Antidiabetics: Possible enhanced hypoglycemic effects.
  • Carbamazepine, cholestyramine, colestipol, barbiturates: Reduces imipramine levels.
  • Ethanol: Enhanced motor skill impairment.
  • Guanethidine, guanfacine: Inhibition of antihypertensive effect.
  • Isoproterenol and possibly other alpha-agonists: Increased risk of arrhythmias.
  • Lithium: Possible increased CNS toxicity, especially in elderly.
  • Phenothiazines, cimetidine, calcium channel blockers, selective serotonin reuptake inhibitors, quinidine, ritonavir, indinavir: Increased tofranil levels.
  • Phenylephrine: Enhanced pressor response.
  • Propantheline: Excessive anticholinergic effects.
Alcohol, grapefruit juice.

Valerian, St. John’s wort, SAMe, kava kava.

FDA Pregnancy Risk Category D. Excreted in breast milk. Breast-feeding is not recommended during therapy with this drug.

  • Withdrawal symptoms (headache, nausea, vomiting, muscle pain, weakness) may occur if drug discontinued abruptly.
  • At doses of 20 mg/kg ventricular arrhythmias occur.

  • The TCA-type antidepressants seem to vary in the way they are absorbed, distributed, and excreted in the body. In a review article published in Current Medical Research and Opinion, tofranil was occasionally used for migraine prevention. The U.S. Headache Consortium recommends imipramine for migraine prevention in their practice guidelines.

    With the exception of amitriptyline, the TCAs have not been thoroughly studied for migraine prevention; a search of the medical literature produced very little evidence of its use for migraine prevention. In one article, researchers with the Adelman Headache Center in Greensboro, North Carolina, noted that imipramine is very inexpensive for migraine prevention, and recommended that it replace another drug as a second-line drug for treating this condition.

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    Imipramine antidepressant is a prescription drug that comes in 25 mg, 75 mg tablets. It is available on prescription only as tablets for oral use, but the online pharmacy, will sell Tofranil without prescription. You may be able to order Tofranil from them online and save the local pharmacy markup.

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    What is Imipramine?
    This drug is used to treat depression and other disorders. It works by increasing the levels of norepinephrine and serotonin in the body by inhibiting uptake of these chemicals by neurons.


    Dibenzazepine derivative; tertiary amine.

    Antidepressant, tricyclic; antiincontinence agent.
    Tablets — Oral 25 mg, 75 mg.
    PO / IM 75-100 mg/day in divided doses, may increase by 25-50 mg to 200 mg, not to exceed 300 mg/day; may give daily dose hs.
    Depression: PO: 1.5 mg/kg/d, increasing by 1-1.5 mg/kg/d q 3-5 days to maximum 5 mg/kg/d.
    Enuresis: (>5 yr): PO: 25 mg qhs, increase to 50 mg in 1 wk Maximum dose 2.5 mg/kg/d or 75 mg.