- What exactly is Tofranil?
- Is there a generic version of Tofranil available?
- When did the U.S. Food and Drug Administration (FDA) approve the medication?
- What are the major differences between Tofranil and other medications used to treat ADHD?
- Concerned about ADHD?
- Can children take Tofranil?
- Are there potential interaction issues for people taking Tofranil and any other drugs?
- Are there any other medical conditions that would make someone ineligible for Tofranil therapy?
- What is the typical dose that would be prescribed to someone taking Tofranil?
- What do I do if I miss a dose?
- What are Tofranil’s common side effects?
- Are there any possible psychiatric side effects that come from taking Tofranil?
- Is it safe for a woman who is pregnant, about to become pregnant, or nursing to take Tofranil?
- Can symptoms occur if Tofranil is discontinued?
- What should I do if I overdose on Tofranil?
- Is Tofranil habit-forming?
- How much does Tofranil cost?
- Are there any disadvantages to Tofranil?
- Generic Name: Imipramine (im-IP-ra-meen)
- Best antidepressant for anxiety according to our readers
What exactly is Tofranil?
Tofranil is a tricyclic antidepressant and brand name of the drug imipramine. It works by restoring balance to chemicals in the brain that helps regulate mood. The medication has been approved for treating depression in adults and nocturnal enuresis in children 6 and older. The medication is also sometimes used to treat symptoms of hyperactivity and impulsivity in patients with attention deficit hyperactivity disorder when traditional medications are ineffective.
Is there a generic version of Tofranil available?
Yes, the generic version of Tofranil is called imipramine and is available for purchase.
When did the U.S. Food and Drug Administration (FDA) approve the medication?
Tofranil was first approved by the FDA in 1984.
What are the major differences between Tofranil and other medications used to treat ADHD?
Most traditional ADHD medications are stimulants. They can be very effective in treating symptoms, but they can be habit-forming. When stimulants are not effective, tricyclic antidepressants (TCAs) like Tofranil are sometimes prescribed. Tofranil can be effective for adults with ADHD and also in treating symptoms of depression and anxiety that often accompany ADHD. However, because it an antidepressant, it takes 2 to 4 weeks for TCAs like Tofranil to reach maximum efficacy.
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Can children take Tofranil?
Very small doses of Tofranil are sometimes prescribed for nocturnal enuresis (involuntary urination), but the effectiveness and safety of the medication for treating other conditions in children such as ADHD has not been established.
Are there potential interaction issues for people taking Tofranil and any other drugs?
Do not take Tofranil if you have taken an MAO inhibitor in the past two weeks, as a dangerous interaction effect could occur. There are also hundreds of drugs which are known to interact with Tofranil in major, moderate, or mild ways, so let your doctor know what other medications you are taking before you begin taking the medication. Some of these can include but are not limited to SSRIs, anticholinergic drugs, decongestants, local anesthetics, and methylphenidate.
Are there any other medical conditions that would make someone ineligible for Tofranil therapy?
Talk to your doctor if you have glaucoma, seizures, heart disease, diabetes, kidney problems, liver problems, or a history of other mental illness, suicidal thoughts, or substance use.
What is the typical dose that would be prescribed to someone taking Tofranil?
The typical dosage ranges between 75 mg and 150 mg daily, and doses above 200 mg are not recommended.
What do I do if I miss a dose?
Take the dose of Tofranil when you remember, but skip the missed dose if it is almost time for your next dose. You should never take extra doses of the medication to make up for missed doses.
What are Tofranil’s common side effects?
Common side effects of Tofranil can include:
- changes in appetite
- dry mouth
- sensitivity to sunlight
- trouble urinating
- changes in sex drive
If you experience major side effects, report them to your doctor immediately and stop using the medication. Major side effects can include but are not limited trouble speaking, tremors, trouble breathing or swelling, irregular heartbeat, rash, yellowing of skin or eyes, muscle spasms, or shuffling walk. You can report side effects to the FDA at 1-800-FDA-1088 or online.
Are there any possible psychiatric side effects that come from taking Tofranil?
Anxiety or agitation are possible side effects of Tofranil. Sometimes antidepressants can cause or increase suicidal thoughts in children or adults. If you have a personal history or family history of bipolar disorder, talk to your doctor about the risks.
Is it safe for a woman who is pregnant, about to become pregnant, or nursing to take Tofranil?
Studies have found that taking antidepressants while pregnant can lead to abnormalities and increase the risk of premature delivery. The drug can be transferred via breast milk but it is unknown whether it is harmful to the nursing infant. Therefore, talk to your doctor if you are pregnant, planning to become pregnant, or are nursing before you take Tofranil.
Can symptoms occur if Tofranil is discontinued?
Withdrawal symptoms of Tofranil can include but are not limited to flu-like symptoms, sleep problems, crying spells, and lack of coordination. It is not recommended that antidepressant use is stopped abruptly, so talk to your doctor before you discontinue use and seek medical attention if necessary.
What should I do if I overdose on Tofranil?
An overdose of Tofranil could be fatal, so seek help immediately or call the Poison Help Line at 1-800-222-1222 if you overdose. Overdose symptoms can include confusion, agitation, seizures, depression, hallucinations, slow breathing, trouble urinating, blurred vision, dilated pupils, low blood pressure, irregular or rapid heartbeat, and coma.
Is Tofranil habit-forming?
Tofranil is not habit-forming, but withdrawal symptoms can occur, so talk to your doctor before you discontinue use.
How much does Tofranil cost?
According to goodrx.com, 30 tablets of 25 mg Tofranil cost approximately $430. The cost of the generic version imipramine is around $10.
Are there any disadvantages to Tofranil?
The biggest disadvantage of Tofranil is that it can cause suicidal thoughts in people taking the medication. Patients are also advised not to drink alcohol while taking the medication. Unlike many other medications used to treat ADHD, the drug takes several weeks for the effects to be felt. Also, common side effects of the medication may outweigh the benefits.
DISCLAIMER: The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other healthcare providers. This article mentions drugs that were FDA-approved and available at the time of publication and may not include all possible drug interactions or all FDA warnings or alerts. The author of this page explicitly does not endorse this drug or any specific treatment method. If you have health questions or concerns about interactions, please check with your physician or go to the FDA site for a comprehensive list of warnings.
Article Sources Last Updated: Feb 21, 2018
Generic Name: Imipramine (im-IP-ra-meen)
Drug Class: Antidepressant, Tricyclic
Table of Contents
- How to Take It
- Side Effects
- Warnings & Precautions
- Drug Interactions
- Dosage & Missing a Dose
- Pregnancy or Nursing
- More Information
Tofranil (imipramine) is a tricyclic antidepressant (TCA) used for treatment of various forms of depression. It increases the activity of certain chemicals in the brain that help elevate mood. Your doctor may prescribe this medicine for other conditions as well.
It is important for family and caregivers to closely watch patients who take imipramine.
Tofranil is also used to treat nighttime bed-wedding in children, along with other therapies. It is not approved for use in all children.
This information is for educational purposes only. Not every known side effect, adverse effect, or drug interaction is in this database. If you have questions about your medicines, talk to your health care provider.
It works by helping change certain chemicals in the brain, which professionals refer to as “neurotransmitters.” It is not yet well-understood why changing these neurochemicals results in symptom relief for the conditions this drug is commonly prescribed for.
How to Take It
Take this medicine as directed. This medicine is taken orally and can be taken with or without food. Do not stop taking this medicine abruptly without consulting with your doctor.
Side effects that may occur while taking this medicine include:
- changes in weight, weight gain
- dry mouth
- dilated pupils
- blurred vision
Contact your doctor immediately if you experience:
- hearing loss
- painful or difficult urination
- abdominal or stomach pain
- lack of coordination
- clay-colored stools
- facial swelling
- unusual tiredness or weakness
- difficulty sleeping
Warnings & Precautions
- DO NOT use this medication if you have taken monoamine oxidase inhibitor in the last two weeks.
- Check your blood sugar regularly if you are taking this medication and have diabetes. Tell your doctor if you are excessively thirsty or hungry, and experience shakiness or unusual sweating.
- DO NOT use this medication if you have narrow angle glaucoma.
- DO NOT use this medication if you are recovering from a recent heart attack.
- Elderly patients may find they become dizzy following use of this medication.
- Sun sensitivity may be higher for those on this medication. Do not stay in the sun for too long, or use sunlamps or tanning booths. Use sunscreen and wear protective clothing when outdoors.
- This medicine may cause dizziness or drowsiness. Alcoholic beverages can increase the side effects of this medicine and should be avoided.
- For an overdose, seek medical attention immediately. For non-emergencies, contact your local or regional poison control center at 1-800-222-1222.
Possible drug interactions may occur with this medicine and phenobarbital as well as MAO inhibitors (severe).
Dosage & Missed Dose
Generic imipramine is available as a tablet.
Tofranil is available in tablet form in 10 mg, 25 mg, and 50 mg strengths. There is also an injection available.
Tofranil-PM tablets are available in 75 mg, 100 mg, 125 mg, and 150 mg strengths.
Imipramine dosage varies based on the condition that is being treated.
If you miss a dose, take your next dose as soon as you remember. If it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not double doses or take extra medicine to make up for the missed dose.
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (preferably not in the bathroom). Throw away any medication that is outdated or no longer needed.
During pregnancy, this medication should be used only if absolutely necessary. Infants may be born with problems, including seizures, trouble urinating, prolonged sleepiness, or shaking. Discuss the risks and benefits with your doctor.
Do not stop taking this medication unless directed by your doctor. If you become pregnant, tell your doctor immediately so you can discuss the benefits and risks of using this medication during pregnancy.
Tofranil passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
For more information, talk to your doctor, pharmacist, or health care provider, or you can visit this website, https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682389.html for additional information from the manufacturer of this drug.
Best antidepressant for anxiety according to our readers
Most respondents—78 percent—received medication for their depression or anxiety, reflecting the tremendous growth of the use of antidepressant drugs in the past 15 years. According to IMS Health, a group that monitors drug sales, U.S. doctors prescribed $9.9 billion worth of antidepressants in 2009, a 3 percent growth over the previous year. They’re the third most prescribed class of drugs in the country, after cholesterol-lowering drugs and codeine-based painkillers, thanks at least in part to years of aggressive marketing.
Drugmakers spent almost $300 million in 2009 on ads for two newer antidepressants alone: duloxetine (Cymbalta: “When you’re depressed, where do you want to go? Nowhere.”) and desvenlafaxine (Pristiq: “I feel like I have to wind myself up just to get out of bed.”).
Reflecting national trends, most recipients of medication in our survey got an SSRI (selective serotonin reuptake inhibitor) such as fluoxetine or sertraline; many others got an SNRI (serotonin and norepinephrine reuptake inhibitor) such as venlafaxine or duloxetine. The drugs alter the levels of certain brain chemicals, or neurotransmitters, that carry signals between nerve cells. The Food and Drug Administration has approved SSRIs and SNRIs as standard first-line treatments for depression and anxiety disorders.
Forty-seven percent of respondents got their prescription from a psychiatrist; the rest obtained it from their primary-care physician, whom they saw separately or as an adjunct to talk therapy with a mental-health professional. That’s consistent with national data that show primary-care doctors, not psychiatrists, prescribe the majority of SSRIs and SNRIs and have done so for at least the last five years.
One size doesn’t fit all
Some SSRIs and SNRIs are promoted for particular types of anxiety, such as social anxiety or obsessive-compulsive disorder. But clinical evidence shows that they work equally well for each major form of anxiety. And individuals don’t all react the same way to these drugs, so it can take some trial and error to find the one that works best for you. Among respondents who took medication for anxiety or depression, the median number of drugs tried was three. Respondents who tried three medications had slightly better outcomes than those who tried fewer or more, suggesting that trial and error is an important part of pharmaceutical treatment.
Expect some side effects
As with all drugs, antidepressants have side effects. But our findings suggest they can be a lot more common than what’s reported in the package inserts you get when you fill your prescription. For example, 31 percent of people we surveyed who took SSRIs and 36 percent of those who took SNRIs reported a decrease in sexual interest or ability (see Readers Rate Antidepressants). That’s more than double the rate reported in studies sponsored by drug companies, which can carefully choose their participants and tend to pick those least likely to experience adverse effects.
Interestingly, men reported more sexual side effects than women, while women complained more often about weight gain. It may be a true physiological difference, or women may simply be more bothered by weight gain and men by sexual difficulties.
The sexual side-effect rates from the current survey are lower than those we found in 2004, when up to 53 percent of respondents reported them. “It’s possible that health-care providers are either prescribing antidepressants that are less likely to cause these problems, such as bupropion (Wellbutrin and generic) or are adding another drug in as an antidote to help counteract the sexual side effects,” said Anita Clayton, M.D., a professor of psychiatry and obstetrics and gynecology at the University of Virginia.
For many respondents, side effects proved more than mere annoyances: Of those who’d stopped taking an antidepressant, 33 percent said they did so because of intolerable side effects. Still, the drugs helped a lot for about half of the people who took them and at least somewhat for another 30 percent. And people who took the drugs in conjunction with talk therapy fared especially well.
Use tranquilizers selectively
For the 58 percent of respondents who experienced anxiety, we also asked about benzodiazepines, an older class of anti-anxiety drugs that includes alprazolam (Xanax and generic) and lorazepam (Ativan and generic). About one-quarter had tried a benzodiazepine; of those, 57 percent said it helped “a lot.” The drugs can cause dizziness and drowsiness, though, and unlike SSRIs and SNRIs, their daily use can lead to dependence. Our medical consultants say they’re best for short-term “rescue” situations, such as quelling a panic attack or helping a fearful flyer board a plane.
What to do
Consumer Reports Best Buy Drugs, a public education project that generates drug recommendations based on safety, efficacy, and price, says that generic bupropion, citalopram, fluoxetine, and sertraline are among the best initial options to consider for depression. Ask your doctor whether you can start at the lowest dose possible. If the first drug hasn’t helped within six to eight weeks, talk with your doctor about increasing the dose or switching to a different drug. Don’t take bupropion if you have a history of seizures, since it carries a risk of seizures at high doses. Discuss with your doctor the potential side effects and how long you’ll probably need to take the drug (most respondents had been taking theirs for at least two years). Don’t stop taking an antidepressant suddenly, which could cause withdrawal symptoms.