Imipramine: What It Does and How to Use It Safely

Imipramine is a tricyclic antidepressant (TCA) that’s been around for decades. Doctors prescribe it for depression, some types of chronic pain, and bedwetting in children. It works by changing brain chemicals that affect mood and bladder control. If your doctor suggested imipramine, here’s a plain guide to what to expect and how to stay safe.

How to Take Imipramine

Start low, go slow. Typical adult doses begin at 25–50 mg a day and may increase up to 150–200 mg depending on the problem and how you tolerate it. Many people take the full dose at bedtime because it commonly causes drowsiness. For bedwetting, lower doses are used and given at night. Always follow your prescriber’s instructions—dosing varies by condition, age, and other meds.

If you miss a dose, take it as soon as you remember unless it’s near the next dose. Don’t double up. When stopping imipramine, your doctor will usually taper the dose slowly to avoid withdrawal symptoms like irritability, nausea, or sleep problems.

Common Side Effects & What to Watch For

Expect dry mouth, constipation, blurred vision, drowsiness, and sometimes weight gain. These are typical anticholinergic effects. Some people notice dizziness or lightheadedness when standing; rise slowly to reduce this. Less common but more serious: fast or irregular heartbeat, fainting, severe confusion, or seizures. If you have chest pain or fainting, get medical help right away.

Imipramine can raise suicide risk in young adults and teens when starting or changing doses. If you or someone in your care has new or worsening mood changes, talk to your clinician immediately.

Interactions are important. Don’t mix imipramine with MAO inhibitors, and be careful with SSRIs, tramadol, or anything that raises serotonin—this can cause serotonin syndrome. Alcohol and other sedatives increase drowsiness and the risk of falls. Tell your provider about blood pressure meds, heart meds, and supplements you take.

Special groups: older adults are more prone to confusion, falls, and heart effects, so lower doses are common. During pregnancy or breastfeeding, the risks and benefits should be discussed with your doctor. Imipramine crosses the placenta and can affect infants.

Before starting, your clinician may check blood pressure, heart rate, and sometimes an ECG if you have heart disease or are older. Follow-up visits in the first few weeks are important to track response and side effects.

Buying and prescriptions: Imipramine requires a prescription in most countries. Use a licensed pharmacy and avoid unverified online sellers. If cost or access is an issue, ask your provider about generics or patient assistance programs.

Questions for your prescriber: What dose should I start with? How long until it helps? What side effects should I report now? How will we stop the drug if needed? Clear answers make treatment safer and more effective.

If you’re unsure whether imipramine is right for you, talk to your doctor or a pharmacist. They can match the medicine to your health needs and help you avoid the risks that matter most.