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Compare Tofranil vs. Paxil

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

Key takeaways

Imipramine (Tofranil) and paroxetine (Paxil) are both used to treat depression, but they belong to different medication classes. Imipramine is a tricyclic antidepressant (TCA) that also helps with bedwetting in children, while paroxetine is a selective serotonin reuptake inhibitor (SSRI) that treats various anxiety disorders, including panic disorder, social anxiety disorder, and post-traumatic stress disorder. Both medications can cause dry mouth, nausea, and sleepiness. Additionally, imipramine can cause a higher risk of heart problems. Paroxetine, on the other hand, can cause serotonin syndrome, sexual side effects, and weight gain. Both medications can increase the risk of suicidal thoughts, especially in younger individuals. Additionally, both medications can cause withdrawal symptoms if stopped suddenly and are available as low-cost generics.

  • Imipramine
    Paroxetine (Paxil)
  • Imipramine
    Paroxetine (Paxil)

  • Summary of Tofranil vs. Paxil

    Summary for Tricyclic antidepressant
    Prescription only

    Imipramine is a medication that's used to treat depression. It can also temporarily help with bedwetting in children at night. Imipramine belongs to a class of medications called tricyclic antidepressants (TCAs). There are two different forms of the medication: imipramine hydrochloride and imipramine pamoate. They used to be available under the brand name Tofranil but are now only sold as generic versions. The dosage generally depends on why you need imipramine, how severe your symptoms are, and your age. It's generally not a first-choice option because it can cause a lot of side effects, like sleepiness, dizziness, dry mouth, and changes in weight.

    Summary for SSRI
    Prescription only

    Paroxetine (also known by it's brand name Paxil) is a selective serotonin reuptake inhibitor (SSRI), used for different types of anxiety problems and depression. It's available as a brand name and generic version, and it comes as an immediate-release tablet, an oral suspension, and an extended-release tablet. Possible side effects include nausea, sexual side effects, and weight gain. It can also cause withdrawal symptoms (e.g., headache, trouble sleeping, anxiety) if you suddenly stop taking it.

  • Indications of Tofranil vs. Paxil

    Indications for
    •Depression
    •Bedwetting in children (imipramine hydrochloride only)
    Indications for
    •Depression
    •Panic disorder (PD)
    •Social anxiety disorder (SAD)
    •Obsessive-compulsive disorder (OCD) (IR only)
    •Generalized anxiety disorder (GAD) (IR only)
    •Post-traumatic stress disorder (PTSD) (IR only)
    •Premenstrual dysphoric disorder (PMDD) (ER only)

  • Pros and Cons of Tofranil vs. Paxil

    Pros and Const for Tricyclic antidepressant
    Pros
    •Available as a lower-cost generic
    •Can take with or without food
    •Dose can be adjusted by your provider based on how well the medication is working for you
    •For bedwetting, only needs to be taken right before bedtime
    Cons
    •Can cause a lot of side effects, including blurry vision, dry mouth, and eye pain
    •Can cause withdrawal symptoms if you stop taking it too suddenly after long-term use
    •Has a risk for suicidal thoughts and behavior
    •Not a good option for people with a history of heart problems
    Pros and Const for SSRI
    Pros
    •Only needs to be taken once daily
    •Available as a tablet and oral liquid
    •Can be taken with or without food
    •Can be used for many different mental health conditions
    •Can be helpful for people who have both anxiety and depression
    Cons
    •Can take several weeks or months to achieve the full benefits
    •Might be more likely than other SSRIs to cause weight gain or sexual problems
    •Can interact with other medications, especially those affecting serotonin levels
    •Can cause withdrawal symptoms if you suddenly stop taking it

  • Common Side Effects of Tofranil vs. Paxil

    Common Side Effects for

    In adults (with depression)

    •Dry mouth
    •Blurry vision
    •Nausea
    •Vomiting
    •Constipation
    •Sleepiness
    •Dizziness
    •Confusion
    •Anxiety
    •Restlessness

    In children (with bedwetting problems)

    •Nervousness
    •Sleep problems
    •Tiredness
    •Stomach upset
    Common Side Effects for
    •Abnormal ejaculation (up to 28%)
    •Nausea (up to 25%)
    •Weakness (up to 22%)
    •Sleepiness or trouble sleeping (up to 24%)
    •Dry mouth (up to 18%)
    •Constipation (up to 16%)
    •Sweating (up to 14%)
    •Dizziness (up to 14%)
    •Diarrhea (up to 12%)
    •Low libido (up to 12%)
    •Shakiness (up to 11%)

  • Warnings of Tofranil vs. Paxil

    Common Side Effects for
    •Worsening depression, suicidal thoughts, and unusual behavior
    •Not for use alone in bipolar disorder
    •Risk of heart problems, heart attack, or stroke
    •Glaucoma
    •Higher risk of falls
    •Seizures
    Common Side Effects for
    •Worsening depression, suicidal thoughts, and unusual behavior
    •Serotonin syndrome
    •Risk of harm to unborn babies
    •Sexual problems
    •Withdrawal
    •Risk factors: Stopping paroxetine (Paxil) suddenly
    •Risk of bleeding
    •Not for use alone in bipolar disorder
    •Glaucoma
    •Low blood sodium levels
    •Seizures
    •Risk of abnormal heart rhythm from interactions

  • Prices with our coupons for Tofranil vs. Paxil

    Learn more about Imipramine
    Learn more about Paroxetine

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