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Two medicines, side by side

Imipramine vs sertraline

Imipramine and sertraline are both labeled for depression. Drugs@FDA records approvals of imipramine since 1959 and of sertraline since 1991. Pharmacies paid $0.0698 per imipramine HCl 10 mg tablet and $0.0507 per sertraline HCl 100 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, imipramine is a tricyclic antidepressant and sertraline a serotonin reuptake inhibitor.

Check it at the source: the imipramine FDA label on DailyMed (effective August 11, 2026); the sertraline FDA label on DailyMed (effective August 8, 2023).

Highlights of the imipramine record

Imipramine (Presamine) · label of August 11, 2026

Boxed warning

Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of imipramine hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need.

Used for

From the label: indications

Depression - For the relief of symptoms of depression. Endogenous depression is more likely to be alleviated than other depressive states. One to three weeks of treatment may be needed before optimal therapeutic effects are evident. […]

On the market

Earliest approval on file
April 16, 1959
Generic labelers
14 labelers
Pharmacy cost
$0.0698 per tablet

Supply and safety

Shortage
No current entry
Recalls
4

Highlights of the sertraline record

Sertraline (Zoloft) · label of August 8, 2023

Boxed warning

SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [See Warnings and Precautions (5.1) ]. WARNING: SUICIDAL THOUGHTS AND BEHAVIORS See full prescribing information for complete boxed warning.

Used for

From the label: indications

ZOLOFT is indicated for the treatment of the following [See Clinical Studies (14) ]: • Major depressive disorder (MDD) • Obsessive-compulsive disorder (OCD) • Panic disorder (PD) • Posttraumatic stress disorder (PTSD) • Social anxiety disorder (SAD) • Premenstrual dysphoric disorder (PMDD) ZOLOFT is a selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of ( 1 ): • Major depressive disorder […]

On the market

Earliest approval on file
December 30, 1991
Generic labelers
47 labelers
Pharmacy cost
$0.0507 per tablet

Supply and safety

Shortage
No current entry
Recalls
3

Source: FDA drug labels via openFDA (Imipramine label of August 11, 2026, Sertraline label of August 8, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)

How do imipramine and sertraline differ on the record?

In FDA's classes, imipramine is a tricyclic antidepressant and sertraline a serotonin reuptake inhibitor.

How each works, in its label's words: Imipramine, “of imipramine hydrochloride, is not definitely known.”; Sertraline, “Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).”

Both labels carry a boxed warning; the records quote them.

Generics: imipramine since 1974; sertraline since 2006 (Drugs@FDA).

ImipramineSertraline
Labeled forDepressionDepression, Anxiety
Pharmacologic classTricyclic AntidepressantSerotonin Reuptake Inhibitor
How it works (label)of imipramine hydrochloride, is not definitely known. However, it does not act primarily by stimulation of the central nervous system.Sertraline potentiates serotonergic activity in the central nervous system through inhibition of neuronal reuptake of serotonin (5-HT).
Half-life (label)n/aThe average terminal elimination half-life of plasma sertraline is about 26 hours.
Earliest approval on file (Drugs@FDA)April 16, 1959December 30, 1991
First generic approvedJune 27, 1974June 30, 2006
Generic labelers (NDC)14 labelers47 labelers
Pharmacy cost (NADAC, each one's most listed form; strengths differ)$0.0698 per tablet (Imipramine HCl 10 mg tablet)$0.0507 per tablet (Sertraline HCl 100 mg tablet)
12-month price change-12%-3%
Boxed warningYesYes
Shortage nowNo current entryNo current entry
Recalls recorded43
FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used)723218,311
DEA schedulenonenone

Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)

Do their labels mention each other?

Imipramine label, drug interactions

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.

What both labels say about taking them together

Source: FDA drug labels via openFDA

What do the labels say about using others of their kind?

Sertraline label, warnings and precautions

Increased risk when co-administered with other serotonergic agents, but also when taken alone.

Source: FDA drug labels via openFDA

What next?

Alternatives to imipramine
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