How common is it to misprescribe tofranil (imipramine)?

Difficult to know: Tofranil, also known as imipramine, is a tricyclic antidepressant (tca). It's an older medication, but one that still has much clinical utility. It can be useful for depression, anxiety, chronic pain and insomnia. It should be avoided in patients with bipolar disorder -- even during the depressed phase -- because tcas can precipitate mania. Side effects (constipation, etc.) can be prohibitive.