Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
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 that
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. Compared with trazodone, nefazodone has a lesser risk of priapism
(prolonged penile erection). The FDA approved nefazodone in December 1994.
PRESCRIPTION: Yes
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. 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.
Nefazodone may increase the blood concentration of several drugs by reducing
their removal by the liver. Through this mechanism nefazodone may markedly
increase the blood concentrations of triazolam (Halcion) and alprazolam (Xanax),
resulting in excessive sedation and impaired ability to perform tasks. It is
recommended that people taking triazolam who need to be started on nefazodone
should have their triazolam dose reduced by 75%. Similarly, those people taking
alprazolam who need to take nefazodone should have their alprazolam dose reduced
by 50%. Nefazodone also may increase the blood concentration and possibly the
side effects of eletriptan (Relpax), eplerenone (Inspra), pimozide (Orap),
ranolazine (Ranexa), and silodosin (Rapaflo).
Carbamazepine (Tegretol,
Tegretol XR, Equetro, Carbatrol) may decrease nefazodone blood levels and possibly its
effectiveness by increasing nefadone's removal by the liver. Conversely,
nefazodone may increase the levels of carbamazepine, possibly leading to
toxicity, by decreasing the removal of carbamazepine by the liver.
PREGNANCY: There are no adequate studies of nefazodone in
pregnant women.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Posttraumatic Stress Disorder - Read about posttraumatic stress disorder (PTSD) symptoms (nightmares, flashbacks), causes (war, traumatic events), effects (depression, suicide) and treatment (medication, therapy).
- trazodone, Desyrel - Read about trazodone (Desyrel), a drug used for the treatment of depression, panic attacks, agoraphobia, cocaine withdrawal, and agressive behavior.
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