Imipramine: What it’s for and what to watch for

Imipramine is a tricyclic antidepressant (TCA) you may see prescribed for depression, certain anxiety symptoms, and bedwetting in children. It can work well when other drugs haven’t helped, but it comes with a clear set of side effects and safety steps to follow. This short, practical guide explains how it works, typical doses, common side effects, and simple tips to stay safer while taking it.

How imipramine works and what it’s used for

Imipramine raises levels of serotonin and norepinephrine in the brain by slowing their reuptake. That helps lift mood, reduce panic-type symptoms, and can change bladder control in kids with nocturnal enuresis (bedwetting). Doctors also sometimes use it off-label for certain chronic pain states or sleep problems when other options fail.

Typical uses you might hear about: moderate to severe depression, treatment-resistant cases after other antidepressants, and short-term treatment of bedwetting in children who don’t respond to behavior changes or alarms.

Safe use: doses, side effects, and practical tips

Dosing varies by reason for use and by patient. Adults usually start low and increase slowly. Common starting amounts are 25–50 mg at night, with typical therapeutic ranges around 75–150 mg per day. Some people need up to 200–300 mg daily under close medical supervision. For children with bedwetting, doctors often use much lower single nightly doses (for example, 10–50 mg), but a pediatrician decides the exact amount.

Watch for side effects that come from its anticholinergic and sedating actions: dry mouth, constipation, blurred vision, drowsiness, weight gain, and light-headedness when standing up (orthostatic hypotension). Heart effects matter too—imipramine can change heart rhythm, so older adults or anyone with heart disease usually needs an ECG before starting.

Serious risks include overdose-related cardiac problems and increased suicidal thoughts in younger people (under 25). Don’t mix imipramine with MAO inhibitors and be cautious combining it with SSRIs or other drugs that raise serotonin—those mixes can cause serotonin syndrome. Alcohol and sedatives can make drowsiness worse.

Simple tips that help: take the dose at night if it makes you sleepy, avoid alcohol, report fast heartbeat or fainting, and don’t stop suddenly—your doctor will recommend a slow taper to avoid withdrawal symptoms. Keep a list of all medications and vitamins you take and show it to your prescriber.

If you’re pregnant, breastfeeding, or have heart disease, seizures, or severe urinary problems, mention this before starting imipramine. In emergencies or overdose, seek immediate medical help—TCA overdoses can be life-threatening.

If you have questions about interaction with other medicines or how imipramine might affect daily life, talk directly with your doctor or pharmacist. They can set the right dose and monitoring plan for you or your child.