Tofranil is the brand name for imipramine, one of the older tricyclic antidepressants (TCAs). Even though it’s been around for decades, doctors still use it for depression, certain chronic pain types, and sometimes childhood bedwetting (nocturnal enuresis). If you’re looking for straightforward facts — what it treats, how it feels, and what to watch for — this page gives the essentials.
Imipramine raises levels of key brain chemicals (serotonin and norepinephrine) by blocking their reuptake. That helps mood and can calm nerve pain signals. Typical uses include major depressive episodes, some forms of nerve pain, and off-label work like reducing bedwetting in kids when other options haven’t helped. Doctors sometimes choose Tofranil when newer drugs haven’t worked or when its specific effects match a patient’s symptoms.
Common side effects are dry mouth, drowsiness, constipation, blurred vision, and lightheadedness when standing up. It can also cause weight gain and sexual side effects. Less common but serious problems include fast or irregular heartbeat and low blood pressure. In older adults and people with heart disease, TCAs raise risk for heart rhythm issues — an ECG may be recommended before starting.
Drug interactions matter. Don’t mix Tofranil with MAO inhibitors, and be cautious with SSRIs, SNRIs, certain antipsychotics, and many cold medicines. Combining some drugs can raise the risk of serotonin syndrome or dangerous heart rhythm changes. Alcohol makes drowsiness and dizziness worse. Pregnancy and breastfeeding require a doctor’s input — there are risks and benefits to weigh.
Start low, go slow is the rule. Doctors often begin with a low dose at bedtime to reduce morning grogginess and raise it only if needed. Don’t stop suddenly — tapering over days to weeks helps avoid withdrawal-like symptoms. If used for bedwetting, the child should be closely monitored and the family should discuss safer options like behavioral methods or desmopressin first.
Watch for warning signs: new or worsening depression, suicidal thoughts, fainting, severe dizziness, chest pain, or sudden vision changes. If these happen, contact a clinician or emergency care fast.
Practical tips: take Tofranil with food if it upsets your stomach, avoid driving until you know how it affects you, keep a list of all meds and supplements for your prescriber, and schedule follow-ups to check blood pressure, symptoms, and possibly an ECG. If you’re curious about alternatives, ask about SSRIs for depression, topical or other neuropathic agents for nerve pain, and behavioral or hormonal options for bedwetting.
Want a quick checklist before a doctor visit? Note your current symptoms, other medications, heart or seizure history, pregnancy plans, and any previous reactions to antidepressants. That makes the conversation faster and safer.
Tofranil, known generically as imipramine, is a tricyclic antidepressant for managing depression and nocturnal enuresis in children. Its use in ADHD and the elderly requires caution due to an unestablished safety profile. Side effects range from drowsiness to severe conditions like serotonin syndrome.