Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Imipramine(click to collapse)
1/4 selected
Imipramine
Tofranil
Tricyclic Antidepressant
FDA-approved indications
- Depression (adults)
- Childhood enuresis — temporary adjunctive therapy (6+ years)
Off-label uses
- Panic disorder
- Neuropathic pain
- Chronic pain
Half-life11 to 25 hours
Decision GuideWhen to pick each / when to consider an alternative
Imipramine
Consider when
- Childhood nocturnal enuresis (age ≥6) — only TCA with FDA-approved enuresis indication; mechanism independent of antidepressant effect
- Panic disorder — strongest TCA evidence base for panic (RR 0.75 vs placebo); superior for both response and dropout
- Once-daily dosing preferred — available as imipramine pamoate (75–150 mg capsules) for bedtime dosing vs divided tablets
- Middle-tier TCA tolerability required — better accepted than amitriptyline and clomipramine in Cipriani 2018
- +1 more
Consider an alternative when
- Elderly or fall-risk patient — orthostatic hypotension +++; Beers Criteria 'avoid'; nortriptyline/desipramine preferred in elderly
- CYP2D6 PM genotype — requires dose reduction to 30% of normal; greatest PGx sensitivity among all TCAs
- On CYP2D6 or CYP2C19 inhibitors — dual CYP vulnerability creates broadest drug interaction surface among TCAs
- Sexual function priority — Serretti 2009 arousal OR 10.95 (second-highest of 17 antidepressants); total SD OR 6.43
- +1 more
| Axis | Imipramine TCA |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Agranulocytosis / severe neutropenia | |
| CNS | |
Sedation / somnolence | |
| Metabolic | |
Weight gain | |
| Autonomic | |
Anticholinergic burden | |
Orthostatic hypotension | |
Sweating | |
| Cardiac | |
Cardiac conduction / AV block | |
Blood pressure elevation | |
Heart rate / tachycardia | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Overdose toxicity | |
| Pregnancy | |
Lactation / breastfeeding safety | |