Compare Tofranil vs. Paxil

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Tofranil
(imipramine hydrochloride)

Paxil
(paroxetine)

Improves your mood and stops bedwetting in children. Tofranil (imipramine hydrochloride) is one of the first choice medicines used to treat depression, but it can cause weight gain and sleepiness.Improves mood and helps you relax. Paxil (Paroxetine) is good for treating depression and anxiety but it causes more weight gain, sleepiness, and withdrawal symptoms than other antidepressants.
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Coupons for Tofranil
Best available price for 30 (25mg) tablets of imipramine-hydrochloride
Coupons for Paxil
Best available price for 30 (20mg) tablets of paxil
Reviews & ratings
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Have you used Tofranil (imipramine hydrochloride)?
Worth itNot sureNot worth it
Reviews for Paxil
52%
-52% worse vs. Tofranil
39%
-39% worse vs. Tofranil
24%
+24% better vs. Tofranil
694 reviews
Have you used Paxil (paroxetine)?
Worth itNot sureNot worth it
Side effects
TofranilPaxil

The Tofranil FDA package insert doesn’t have numbers about how common side effects are.

More about Tofranil side effects »
  • Nausea 17%
  • Drowsiness 14%
  • Dry mouth 6%
  • Headache 1%
  • Muscle weakness 9%
  • Constipation 5%
  • Sleep difficulty 7%
  • Ejaculatory disturbance‡§ 13%
  • Dizziness 7%
  • Diarrhea 4%
More Paxil side effects »
How it works
TofranilPaxil
Tofranil (imipramine hydrochloride) is a tricyclic antidepressant. It raises the amount of serotonin and norepinephrine in the brain, 2 chemicals that are known to regulate mood. It's not known exactly how Tofranil (imipramine hydrochloride) treats bedwetting.Paxil (Paroxetine) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It increases serotonin activity in the brain, which regulates mood.
Type of medication
TofranilPaxil
Prescription onlyPrescription only
Available as
TofranilPaxil
  • Pill
  • Pill
  • Extended release tablet
  • Liquid
Used for
TofranilPaxil
Risk factors for serious side effects
TofranilPaxil
  • Under age 24
  • History of heart disease
  • Overactive thyroid
  • High blood pressure
  • History of seizures
Detailed Tofranil (imipramine hydrochloride) risks & warnings »
  • Age 24 years or younger
  • Using other medications that affect serotonin
  • Stopping Paxil (Paroxetine) suddenly
  • Taking other blood-thinning drugs
  • History of bipolar disorder
Detailed Paxil (paroxetine) risks & warnings »
Pregnancy

The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

Research studies with real people found harmful effects on unborn babies, but the benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

Alcohol
TofranilPaxil
  • Don't drink alcohol while taking Tofranil (imipramine hydrochloride).
No alcohol related info.
Food
TofranilPaxil
No food related info.
  • Take with food to avoid upset stomach.
Sleep
TofranilPaxil
  • Tofranil (imipramine hydrochloride) can make you feel sleepy, so don't drive or do anything requiring concentration until you know how it affects you.
  • It causes drowsiness, so it's good for people who have trouble sleeping.
Weight
TofranilPaxil
  • Compared to other medicines for depression, Tofranil (imipramine hydrochloride) can make you more likely to gain weight and have changes in blood sugar. If you have diabetes, your doctor might need to change the doses of your medications to make sure your blood sugar stays controlled. Talk to your doctor to see if you should take another medicine besides Tofranil (imipramine hydrochloride).
  • Can cause weight gain, which can be helpful if you've recently lost weight or have a low appetite.
  • More likely to cause minor weight gain (1 to 5 pounds) or make you feel sick if you miss a dose than other antidepressants.
Upsides and benefits
TofranilPaxil
  • Tofranil (imipramine hydrochloride) is part of the first choice of medicines used to treat depression.
  • Available in generic.
  • Tofranil (imipramine hydrochloride) is usually taken only once a day.
  • Available in 3 different strengths.
  • Effective at relieving depression and anxiety symptoms.
  • Lowers relapse rates of depression and anxiety disorders, including OCD, panic disorder, social anxiety disorder, and generalized anxiety disorder.
  • It causes drowsiness, so it's good for people who have trouble sleeping.
  • Can cause weight gain, which can be helpful if you've recently lost weight or have a low appetite.
  • Six out of ten people who use an antidepressant for the first time find that it works for them.
Downsides and risks
TofranilPaxil
  • Tofranil (imipramine hydrochloride) can lower your sex drive and cause more weight gain than other similar medicines for depression.
  • You might be more sensitive to the sun and have a higher risk for heat stroke while taking Tofranil (imipramine hydrochloride).
  • If you have a history of heart conditions, your symptoms might get worse with Tofranil (imipramine hydrochloride). Talk to your doctor to see if Tofranil (imipramine hydrochloride) is right for you.
  • Can cause more sexual side effects like low libido and an inability to orgasm or ejaculate than most antidepressants.
  • More likely to cause minor weight gain (1 to 5 pounds) or make you feel sick if you miss a dose than other antidepressants.
  • Can harm an unborn child, so you can't take it if you're pregnant.
  • Like most antidepressants, it can cause a higher risk of suicidal thoughts and behavior for people younger than age 24.
  • The first antidepressant you try doesn't always work or it can cause side effects you really don't like. You might need to try a few different medications until you find one that works for you.
Tips from our pharmacists for people taking the medication
TofranilPaxil
  • You might need to take Tofranil (imipramine hydrochloride) for a few weeks before you notice any changes in your mood.
  • Don't drink alcohol while taking Tofranil (imipramine hydrochloride).
  • If you miss your bedtime dose, skip it and take your regular dose the next evening. Don't take extra medicine to make up for the missed dose.
  • You might be more sensitive to the sun while taking Tofranil (imipramine hydrochloride). Make sure to drink plenty of liquids, wear sunscreen, or cover your skin if you'll be out in the sun.
  • Tofranil (imipramine hydrochloride) can make you feel sleepy, so don't drive or do anything requiring concentration until you know how it affects you.
  • Don't stop taking Tofranil (imipramine hydrochloride) without talking to your doctor first.
  • Take with food to avoid upset stomach.
  • Takes about 8 to 12 weeks to see the medication's full effects on your mood.
  • Stop taking it slowly to avoid getting withdrawal symptoms.
  • Tell your doctor if you notice sudden mood changes or unusual thoughts.
  • The controlled-release (CR) tablet can cause less nausea than other forms.
  • Don’t crush, break, or chew the Paxil (Paroxetine) controlled-release tablet or the Pexeva film-coated tablets.
  • It’s best to take Paxil (Paroxetine) in the morning, except Brisdelle, which can be taken at bedtime.
Learn more
More about TofranilSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Tofranil (imipramine hydrochloride)?
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More about PaxilSide effectsReviews & ratingsAlternativesFDA package insert
Have you used Paxil (paroxetine)?
Worth itNot sureNot worth it