Medication evidence profile

Imipramine

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Clinical overview

Antidepressant

Imipramine has public medication-list entries in JARS 2025, Yamada-ABS 2023, BAAS 2019, GABS 2018, KABS 2020 open validation supplement, and CALS 2022 Table 4. These are 6 separate source versions, each with its own evidence and definitions.

Source-specific scores

SourceScore
JARS3
Yamada-ABS3
BAAS3
Swe-ABSNot listed
GABS3
KABS3
CALS3

How to read this: 0 means the source explicitly assigned zero. “Not listed” means the source did not provide a score for this medication. Scores from different scales are not averaged.

How to interpret the evidence

6 of 7 public source versions contain an explicit medication-list entry for imipramine.

The available rows for imipramine display the same numeric value. Agreement of the displayed numbers does not establish identical methods, clinical meaning or patient-level risk.

None of the public rows in this profile is an explicit zero. An unlisted source still supplies no value.

Source labels and provenance · 6 observations
  1. Japanese Anticholinergic Risk Scale (JARS) 2025 English translation

    Source label: Imipramine. Published value: 3.
    Source version: JARS-2025
    Source location: RC4 source recovery; recovery_scope=primary_table_complete; ATC=N06AA02
    Observation: JARS_2025_R0049; rating state: published_rating.

  2. Yamada Pharmacological Anticholinergic Burden Scale 2023

    Source label: Imipramine. Published value: 3.
    Source version: YAMADA-ABS-2023
    Source location: RC4 source recovery; recovery_scope=primary_nonzero_complete
    Observation: YAMADA_ABS_2023_R0069; rating state: published_rating.

  3. Brazilian Anticholinergic Activity Scale 2019

    Source label: Imipramine. Published value: 3.
    Source version: BAAS-2019
    Source location: RC4 source recovery; recovery_scope=primary_table_complete
    Observation: BAAS_2019_R0028; rating state: published_rating.

  4. German Anticholinergic Burden Score 2018

    Source label: Imipramine. Published value: 3.
    Source version: GABS-2018
    Source location: RC4 source recovery; recovery_scope=primary_nonzero_complete
    Observation: GABS_2018_R0137; rating state: published_rating.

  5. KABS 2019 scale - 2020 open validation supplement

    Source label: Imipramine. Published value: 3.
    Source version: KABS-2020-validation-supplement
    Source location: Additional file 1; category Antidepressants; table row 14
    Observation: KABS2020_SUPP_0053; rating state: published_validation_supplement_rating.

  6. CALS 2022 - primary final Table 4

    Source label: Imipramine. Published value: 3.
    Source version: CALS-2022-primary-table4
    Source location: Table 4; literal capture row 14; displayed table row 2; displayed column 7
    Observation: CALS2022_T4_0014; rating state: published_final_table_rating.

Class context — antidepressants with strong anticholinergic activity

For the antidepressants identified by the 2023 AGS Beers Criteria as strongly anticholinergic, the older-adult concern is not limited to one symptom: the criterion also highlights sedation and orthostatic effects. Interpret the Beers criterion separately from each UnifiedACB source score.

AGS Beers 2023 Table 2; AGS Beers 2023 Table 7

Older-adult medication context

AGS Beers context: classification and criteria

AGS Beers 2023 · Strong anticholinergicBeers: Avoid / generally avoid in older adults
  • Table 7: Strong-anticholinergic reference listing.
  • Table 2: General older-adult medication criterion.

Source-scale observations and geriatric criteria answer different questions. The Beers material does not alter any score above.

Adults 65 years and older; intended for ambulatory, acute, and institutional care except hospice/end-of-life settings.

Condition-specific and medication-combination contexts

Table 3: clinical conditions

Condition-specific contexts: delirium or high delirium risk, dementia or cognitive impairment, and history of falls or fractures. Applicability depends on the condition and the relevant source criterion.

Table 5: cumulative anticholinergic exposure

Concurrent use of more than one anticholinergic medication should be minimized because cumulative exposure increases geriatric safety concerns.

American Geriatrics Society 2023 updated AGS Beers Criteria — Tables 2, 3, 5 and 7; selected criterion context.

Potentially inappropriate does not mean absolutely contraindicated. Apply the criterion in clinical context and use shared decision-making.

What this page does not establish

  • No medication-list entry is available here from Swe-ABS 2023. These gaps remain “Not listed”; no score is inferred from another source or from class membership.
  • No route inference unless present in the source label.
  • These source records do not estimate an individual’s probability of harm or establish whether to start, stop or change a medication. Ordinal source scores are not averaged into a UnifiedACB score.

References

  1. Mizokami F, Mizuno T, Taguchi R, et al. Development of the Japanese Anticholinergic Risk Scale: English translation of the Japanese article. Geriatr Gerontol Int. 2025;25(1):5-13. doi:10.1111/ggi.15001. Open source
  2. Yamada S, Mochizuki M, Chimoto J, Futokoro R, Kagota S, Shinozuka K. Development of a pharmacological evidence-based anticholinergic burden scale for medications commonly used in older adults. Geriatr Gerontol Int. 2023;23(7):558-564. doi:10.1111/ggi.14619. Open source
  3. Nery RT, Reis AMM. Development of a Brazilian anticholinergic activity drug scale. Einstein (Sao Paulo). 2019;17(2):eAO4435. doi:10.31744/einstein_journal/2019AO4435. Open source
  4. Kiesel EK, Hopf YM, Drey M. An anticholinergic burden score for German prescribers: score development. BMC Geriatr. 2018;18(1):239. doi:10.1186/s12877-018-0929-6. Open source
  5. Suh Y, Ah YM, Han E, et al. Dose response relationship of cumulative anticholinergic exposure with incident dementia: validation study of Korean anticholinergic burden scale. BMC Geriatr. 2020;20(1):265. doi:10.1186/s12877-020-01671-z. Open source
  6. Ramos H, Moreno L, Pérez-Tur J, Cháfer-Pericás C, García-Lluch G, Pardo J. CRIDECO Anticholinergic Load Scale: an updated anticholinergic burden scale. Comparison with the ACB Scale in Spanish individuals with subjective memory complaints. J Pers Med. 2022;12(2):207. doi:10.3390/jpm12020207. Open source

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