Quick Overview

• Brand name: Tofranil

• Generic name: Imipramine

• Strength: 25 mg

• Drug class: Tricyclic antidepressant (TCA)

• Prescription required

Used For

• Major Depressive Disorder (MDD)

• Anxiety and panic disorders

• Nocturnal enuresis (bedwetting) in children

• Occasionally used off-label for:

  • Chronic pain

  • ADHD

  • Irritable Bowel Syndrome (IBS)

  • Narcolepsy

How It Works

Imipramine increases the levels of norepinephrine and serotonin in the brain by blocking their reuptake. This helps improve mood and relieve symptoms of depression and anxiety. It also has anticholinergic effects, which contribute to some side effects.

How to Take It

• Usual starting dose: 25–50 mg per day, increased gradually

• For depression: Doses may range up to 150–200 mg/day (divided or at bedtime)

• For bedwetting: Lower doses like 10–25 mg at bedtime in children

• Take with or without food

• Do not stop suddenly—must taper off to avoid withdrawal symptoms

Common Side Effects

• Dry mouth

• Constipation

• Drowsiness

• Dizziness

• Blurred vision

• Weight gain

• Trouble urinating

Serious Risks

• Heart rhythm problems (especially in overdose)

• Low blood pressure (orthostatic hypotension)

• Seizures (rare, but dose-dependent)

• Suicidal thoughts in younger patients

• Anticholinergic toxicity (in high doses or in older adults: confusion, hallucinations, urinary retention)

Avoid If You Have:

• Heart problems, like arrhythmias

• Recent heart attack

• Bipolar disorder (unless stabilized—can trigger mania)

• Glaucoma or urinary retention

• Use with MAOIs or SSRIs—can lead to dangerous interactions (serotonin syndrome or hypertensive crisis)

 Summary

Tofranil 25 mg (Imipramine) is an older but still effective tricyclic antidepressant, especially useful for depression, panic attacks, and bedwetting in kids. It’s powerful but requires close monitoring due to its heart and anticholinergic side effects.