imipramine vs paroxetine
Side-by-side comparison of imipramine and paroxetine. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
While all the selective serotonin reuptake inhibitors (SSRIs), e.g., fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition.
Recommendation: Your doctor may need to adjust your dose of imipramine and watch for signs of toxicity.
Tofranil
Paxil
Imipramine (Tofranil) is a medicine used to treat depression and bedwetting in children. It helps improve mood and reduce bedwetting episodes.
Paroxetine (Paxil) is a medicine that can help treat depression and anxiety disorders. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).
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.
Paroxetine is used to treat several conditions in adults. These include major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD). It helps to improve mood and reduce anxiety and panic feelings.
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.
Paroxetine works by increasing the amount of serotonin in your brain. Serotonin is a natural substance that helps regulate mood. By increasing serotonin levels, paroxetine can help improve symptoms of depression and anxiety.
- • Dry mouth
- • Blurred vision
- • Constipation
- • Drowsiness
- • Dizziness
- • Abnormal ejaculation
- • Weakness or fatigue
- • Constipation
- • Decreased appetite
- • Diarrhea
- Feeling lightheaded or unsteady 35
- Feeling very tired 30
- High blood pressure 29
- Feeling worried or nervous 28
- Feeling sad or hopeless 28
- Reaction with another medicine 1,825
- Tiredness 1,821
- Feeling sick to your stomach 1,738
- Harmful effect from different substances 1,579
- Worry or nervousness 1,476
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.
Antidepressants may increase the risk of suicidal thoughts and behaviors in young adults. Your doctor will monitor you closely for worsening depression or suicidal thoughts. Paroxetine is not approved for use in children.
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.
Paroxetine may cause harm to your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. Taking paroxetine later in pregnancy may cause problems for the newborn.
Also Compare, Nearby Drugs
Compare imipramine with
Compare paroxetine with
How to Read This imipramine vs paroxetine Comparison
imipramine is classified in the Tricyclic Antidepressant (TCA) drug class, while paroxetine sits within the Selective Serotonin Reuptake Inhibitor (SSRI) class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. 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, imipramine has 150 submissions while paroxetine has 8,439. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to paroxetine blocks the enzyme that breaks down imipramine, which can cause imipramine to build up to high levels in your body.. 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 imipramine and paroxetine - 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.