GENERIC NAME: nefazodone
BRAND NAME: Serzone
DRUG CLASS AND MECHANISM: Nefazodone is an
antidepressant
medication that affects chemicals in the brain that nerves use
to send
messages to each other, 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, an action which results
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. (See side effects.)
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets (hexagonal): 100, 150,
200, and
250 mg.
STORAGE: Tablets should be kept at room temperature,
below 40°C
(104°F).
PRESCRIBED FOR: Nefazodone is indicated for the
management of
depression.
DOSING: Nefazodone is given in two daily 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 (mono-amine oxidase) inhibitor-
class of
antidepressants [for example, isocarboxazid (Marplan),
phenelzine
(Nardil), tranylcypromine (Parnate), and procarbazine
(Matulane)] Such
combinations may lead to confusion, high blood pressure,
tremor, and
increased activity. This same type of interaction may also
occur with
selegiline (Eldepryl), fenfluramine (Pondimin), and
dexfenfluramine
(Redux). If a patient is switched from nefazodone to an MAO
inhibitor, at
least one week should be allowed after stopping the nefazodone.
Nefazodone should not be taken with terfenadine (Seldane) or
astemizole
(Hismanal) since blood concentrations of these two
antihistamines can
increase, and increases can cause potentially life-threatening
abnormal
heart rhythms. Nefazodone can 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 start taking nefazodone should have their
alprazolam dose reduced by 50%. Nefazodone may increase the
blood
concentration of digoxin (Lanoxin), possibly leading to digoxin
toxicity
with side effects such as altered vision or nausea.
PREGNANCY: There are no adequate studies of nefazodone
in
pregnant women. Studies in animals have not demonstrated any
adverse
effects on the developing fetus, but some studies in animals
found that
the animal offspring were of low weight and died more
frequently than
those whose mothers were not exposed to the drug. Nefazodone
can be used
in pregnancy only if the physician feels that its benefits
outweigh its
potential risks.
NURSING MOTHERS: It is not
known if nefazodone is secreted in breast milk.
SIDE EFFECTS: The most commonly noted side effects
associated
with nefazodone are nausea, dizziness, insomnia, agitation,
tiredness, dry
mouth, constipation, lightheadedness, blurred vision, and
confusion.
Rarely, nefazodone is associated with priapism or prolonged
penile
erection. Although the erection usually subsides eventually,
occasionally
blood clots form within the penis and cause serious damage to
the penis.
"If antidepressants are discontinued abruptly, symptoms may occur
such as
dizziness, headache, nausea, changes in mood, or changes in the sense
of
smell, taste, etc. (Such symptoms even may occur when even a few
doses of
antidepressant are missed.) Therefore, it is recommended that the
dose of
antidepressant be reduced gradually when therapy is discontinued."
Last Editorial Review: 12/31/1997
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.
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From the Doctors at MedicineNet.com  |
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- trazodone, Desyrel - Read about trazodone (Desyrel), a drug used for the treatment of depression, panic attacks, agoraphobia, cocaine withdrawal, and agressive behavior. Source:MedicineNet
- Posttraumatic Stress Disorder - Read about post-traumatic stress disorder (PTSD) symptoms (nightmares, flashbacks), causes (war, traumatic events), effects (depression, suicide) and treatment (medications, exposure therapy). Source:MedicineNet
- Read 24 more nefazodone related articles ...
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