Imipramine and Pregnancy
In studies involving imipramine and pregnancy, the medication did not appear to cause any birth defects when it was given to pregnant animals. Although there have been a few reports of birth defects in humans when the drug was taken during pregnancy, it doesn't seem likely that these problems were a result of using imipramine. If you are taking imipramine and pregnancy occurs, you should talk with your healthcare provider. He or she will weigh both the benefits and risks before making a recommendation for your particular situation.
For women who are pregnant, imipramine hydrochloride (Tofranil®) and imipramine pamoate (Tofranil PM®) may not be safe. This is based on animal studies that looked at the effects of imipramine during pregnancy and a few reports of birth defects in humans.
The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. However, the FDA has not given imipramine a pregnancy risk classification, most likely because there is very little information about using imipramine during pregnancy. However, other sources have suggested that the risk to the fetus due to imipramine is low. Most studies of imipramine in pregnant animals did not show any birth defects. There have been a few reports of birth defects in humans -- though it does not seem likely that these problems were caused by imipramine.
Most healthcare providers recommend that pregnant women use newer antidepressants (which have been more thoroughly studied in pregnancy) instead of imipramine. However, your healthcare provider may recommend that you take imipramine during pregnancy if the benefits to you and the fetus outweigh the possible risks to the fetus. In fact, recent studies have suggested that not treating depression in the mother may actually be more harmful to a baby than exposure to antidepressants.