Imipramine: What You Need to Know

Imipramine is a tricyclic antidepressant used for depression and certain nerve-related conditions. Doctors also prescribe it for bedwetting in children (enuresis) and some chronic pain or anxiety problems. If your provider recommended imipramine, this page explains how it works, what to expect, and how to use it safely.

How it works: imipramine raises levels of norepinephrine and serotonin in the brain and calms overactive nerve signals. That helps with mood, panic, and in some cases reduces nighttime urination in kids. It usually takes several weeks to notice full benefits, so patience and follow-up are important.

Dosing and daily use

Typical adult doses start around 50 mg daily and may go up to 150–200 mg depending on response and side effects. Many people take their dose at bedtime because imipramine commonly causes drowsiness. For children treated for bedwetting, doctors use much lower doses and check closely. Don’t stop suddenly—your prescriber will taper the dose to prevent withdrawal symptoms like irritability, nausea, or sleep trouble.

Side effects, interactions, and safety tips

Common side effects are dry mouth, constipation, blurred vision, drowsiness, and lightheadedness. Because imipramine has anticholinergic effects, it can worsen glaucoma or urinary retention. It can also affect heart rhythm—people with heart disease or older adults often need an ECG before and during treatment. If you have seizures, tell your doctor: imipramine may lower the seizure threshold.

Serious warning: young people starting antidepressants have a higher risk of suicidal thoughts. If you or someone you care for shows new or worsening depression, unusual behavior, or suicidal ideas, contact a provider right away. Keep regular check-ins in the first few weeks.

Drug interactions are common. Avoid MAO inhibitors and be cautious with other antidepressants, certain antipsychotics, and drugs that boost serotonin—combining them can cause serotonin syndrome. Alcohol and sedatives add to drowsiness and breathing risks. Mention all prescription meds, supplements, and OTC drugs to your prescriber.

Pregnancy and breastfeeding: imipramine may be used during pregnancy if benefits outweigh risks. It passes into breast milk; watch nursing infants for feeding or sleep changes and discuss risks with your clinician.

Practical tips: keep a simple symptom diary for mood, sleep, bowel habits, and side effects during the first month. Avoid driving until you know how you react. For constipation, increase fluids, fiber, and activity before trying laxatives. Store meds away from children and follow disposal rules for unused pills.

Overdose can be dangerous—seek emergency care for extreme drowsiness, fast or slow heartbeat, seizures, or breathing problems. Ask your prescriber: why this drug over others, how we’ll measure improvement, what tests are needed, and how to stop safely. Clear answers help you get the most benefit while staying safe.