There may be an increased risk of suicidal behavior during treatment with imipramine. In previous studies involving imipramine and suicide, imipramine caused an increased risk of suicidal behavior in children and teenagers who took the medicine. There are certain people who appear to be at a greater risk of suicidal behavior while taking imipramine. Among these people are those with bipolar disorder and those who have attempted suicide in the past.
S. Food and Drug Administration (FDA) has issued a special warning about the risk of suicidal thinking and behavior with antidepressant use in children and teenagers. The warning was issued due to concerns that antidepressants seemed to increase the risk of suicidal behavior in children and teenagers in previous clinical studies.
Although imipramine is not approved for use in children and teenagers with depression, it may be used "off-label" for these age groups. Imipramine hydrochloride (but not imipramine pamoate) is approved for treating bedwetting in children as young as six years old.