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Imipramine is primarily used to treat major depressive disorder. It is also sometimes used to treat enuresis (bedwetting) in children.

Imipramine carries a black box warning regarding an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults when used for the treatment of major depressive disorder and other psychiatric disorders. It is important for healthcare providers to closely monitor patients of all ages for clinical worsening, suicidality, or unusual changes in behavior, especially during the initial few months of treatment or when the dose is adjusted.

Imipramine is primarily used as an antidepressant, but it can also be effective in treating certain anxiety disorders. It belongs to a class of medications called tricyclic antidepressants and may be prescribed for anxiety when other treatments are not suitable or effective. However, the suitability of imipramine for anxiety should be determined by a healthcare provider, who can consider the individual's specific condition and medical history.

Imipramine can cause drowsiness as a side effect, which may make a person feel sleepy. It is important for individuals taking imipramine to be aware of how it affects them, especially when performing tasks that require alertness, such as driving. If drowsiness becomes problematic, it is advisable to consult a healthcare provider.

The most recommended medications for anxiety are typically selective serotonin reuptake inhibitors (SSRIs) such as sertraline or escitalopram, and serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine. Benzodiazepines, such as lorazepam or alprazolam, may also be prescribed for short-term relief. However, the choice of medication depends on the individual's specific symptoms, medical history, and response to treatment, and should be determined by a healthcare provider.