amitriptyline vs imipramine
Side-by-side comparison of amitriptyline and imipramine Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
Elavil
Tofranil
Amitriptyline is a medicine used to treat depression. It may take up to 30 days to feel the full effect.
Imipramine (Tofranil) is a medicine used to treat depression and bedwetting in children. It helps improve mood and reduce bedwetting episodes.
Amitriptyline is used to relieve the symptoms of depression. It works best for a type of depression called endogenous depression. This is depression that comes from within, rather than being caused by outside events.
This medicine can help relieve the symptoms of depression. It may work better for some types of depression than others. Imipramine can also be used to help reduce bedwetting in children 6 years and older, but only after a doctor has ruled out other possible causes.
Amitriptyline belongs to a class of drugs called tricyclic antidepressants (TCAs). It works by increasing the levels of certain chemicals in your brain. These chemicals help improve your mood.
Imipramine is a tricyclic antidepressant. It works by increasing the levels of certain natural chemicals in the brain that help regulate mood. For bedwetting, it's thought to affect bladder control.
- • Drowsiness
- • Dizziness
- • Weakness
- • Fatigue
- • Headache
- • Dry mouth
- • Blurred vision
- • Constipation
- • Drowsiness
- • Dizziness
- Pain 1,564
- Feeling sick to your stomach 1,434
- Head pain 1,380
- Tiredness 1,369
- Shortness of breath 1,340
- Using the medicine for something it's not approved for 37
- Feeling lightheaded or unsteady 35
- The medicine is not working 35
- Feeling very tired 30
- High blood pressure 29
Antidepressants may increase the risk of suicidal thoughts or actions in children, teens, and young adults. Your doctor should closely monitor you for worsening depression or unusual changes in behavior. Amitriptyline is not approved for use in children.
Antidepressants may increase the risk of suicidal thoughts and behavior in children, teenagers, and young adults. Your doctor will monitor you closely for worsening depression, suicidal thoughts, or unusual changes in behavior. Families and caregivers should also watch for these changes.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if amitriptyline will harm your unborn baby. Amitriptyline can pass into breast milk.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. This medicine may not be safe for you or your baby. Talk to your doctor about the risks and benefits.
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How to Read This amitriptyline vs imipramine Comparison
amitriptyline is classified in the Tricyclic Antidepressant (TCA) drug class, while imipramine sits within the Tricyclic Antidepressant (TCA) class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, amitriptyline has 7,087 submissions while imipramine has 166. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between amitriptyline and imipramine — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.