Tricyclic antidepressant
Imipramine hydrochloride
Adult dose
Dose: Depression: 75mg/day initial, increase to 150–200mg/day. Nocturnal enuresis (≥7y): 25–50mg nocte (max 75mg)
Route: PO
Frequency: OD or divided
Clinical pearls
- Nocturnal enuresis when non-pharmacological + desmopressin failed (specialist)
Contraindications
- Recent MI
- Arrhythmia
- Mania
- Severe hepatic impairment
- Concurrent MAOI
Side effects
- Anticholinergic
- Sedation
- Cardiac conduction delay
- Lowered seizure threshold
- Weight gain
- Urinary retention
Interactions
- MAOIs (avoid)
- SSRIs
- QT-prolonging drugs
- CYP2D6 inhibitors
Monitoring
- BP
- ECG if cardiac risk
Reference: BNF; NICE NG28 (children); https://bnf.nice.org.uk/drugs/imipramine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF