drug: nefazodone

• Clinical class: antidepressant
• Action: serotonin (5HT₂) antagonist
• Chemical class: phenyl piperazine
• CSA schedule: none
• DEA number: none
• FDA Medwatch Consumer Advisory (liver failure)
• FDA Medwatch Consumer Advisory (name confusion: Seroquel^® & Serzone^®)
• MEDLINEplus^® Drug Information

U.S. Preparations:

• Serzone^® (Bristol-Myers Squibb) FDA approved: for treatment of depression; WARNING issued 1.9.2002

Preparations Outside U.S.:

• Dutonin, Menfazona, Nefadar, Nefirel, Reseril, Rulivan

Stephen Stahl's Clinical Pearls* (Consult your physician before making any change in your treatment.)

• Be careful in switching from or adding to SSRIs i.e., titrate down on the SSRI and titrate up on nefazodone or side effects will result from the drugs' interaction.
• Agitation and flu-like distress upon first dosing may indicate genetic lack of 2D6 or SSRI- induced 2D6 inhibition from residual SSRI during switching, thus making more mCPP, an anxiogenic metabolite.
• Palinopsia due to partial agonism rather than silent antagonism at 5HT2 receptors.
• Do not underdose the elderly.
• Patients may tolerate all dosing once daily at night.
• Do not confuse with trazodone which is much more sedating.
• For elderly patients with early dementia and agitated depression consider nefazodone qAM plus additional trazodone qhs.

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