GENERIC NAME: nefazodone
BRAND NAME: Serzone (This brand no longer is available in the U.S.)
DRUG CLASS AND MECHANISM: Nefazodone is an oral antidepressant drug. Nefazodone affects chemicals in the brain that nerves use to send messages to one another, called neurotransmitters. The neurotransmitters that are released by nerves are taken up again by the nerves that release them for reuse. Many experts believe that depression is caused by an imbalance among the amounts of neurotransmitters that are released. Nefazodone works by inhibiting the uptake by nerves of serotonin and norepinephrine, two neurotransmitters, resulting in more serotonin and norepinephrine to transmit messages to other nerves. Nefazodone is chemically unrelated to the serotonin reuptake inhibitors (SSRIs), the tricyclic antidepressants (TCAs), or the monoamine oxidase (MAO) inhibitors. It is chemically related to another antidepressant, trazodone (Desyrel) and shares its actions. The FDA approved nefazodone in December 1994.
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 50, 100, 150, 200, and 250 mg.
STORAGE: Tablets of nefazodone should be kept at room temperature, below 40 C (104 F).
PRESCRIBED FOR: Nefazodone is used for the treatment of depression.
DOSING: The recommended dose range is 150-300 mg twice daily. The maximum dose is 600 mg daily. The starting dose is 100 mg twice daily. Doses may be increased weekly by 100 to 200 mg day in two divided doses. As with all antidepressants, the full effect may take a few weeks to become manifest. Doses are often adjusted slowly upward to find the optimal dose. Elderly patients and debilitated persons may need lower doses.
DRUG INTERACTIONS: All antidepressants whose actions include increasing brain concentrations of serotonin, including nefazodone, should not be taken with any of the MAO (monoamine oxidase) inhibitor class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), procarbazine (Matulane), and selegiline (Eldepryl). Such combinations may lead to confusion, high blood pressure, tremor, and increased activity. If a patient is switched from nefazodone to an MAO inhibitor, at least one week should be allowed after stopping nefazodone before starting the MAO inhibitor. Two weeks should be allowed between stopping an MAO inhibitor and initiating treatment with nefazodone.
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