nefazodone SERZONE

Class: SARI/​Phenylpiperazine
FDA Indications: MDD, Relapse Prevention In MDD
Off-Label Use: PTSD, Panic Disorder
Prescribing
Forms: 50, 100, 150, 200, 250mg tablet
Dose Range: 200-600 mg/day
Starting: 100 mg bid, titrate as tolerated up to max dose 600 mg bid; typically most effective in the 300-600mg/day range

NAMI drug fact sheet

Precautions
Contraindications: active liver disease or with elevated baseline serum transaminases
Serious Side Effects: hepatotoxicity ~ 1 in 250,000 per year of treatment
Side Effects: headache, sedation/somnolence, dizziness, confusion, ataxia, visual changes, weakness/asthenia, constipation, increased appetite, xerostomia, nausea, insomnia, agitation, orthostatic hypotension, dyspepsia, memory impairment, paresthesia
Pharmacodynamics
1° MOA: Serotonin Antagonist/reuptake Inhibitor
2° MOA: Norepinephrine reuptake inhibition
Target: Antagonism at:
Pharmacokinetics
t½: 3.5 (2-4)° TMAX:
Substrate of: 3A4
Inhibits: 3A4, 2D6; Induces:
Active Metabolites: HO-NEF, mCPP, Triazole-dione
DDIs
Misc
  • - nonlinear pharmacokinetics; inhibits its own metabolism
  • - Food delays the absorption and decreases its bioavailability ~20%
  • - very effective antidepressant
  • - more sedating than other antidepressants, but causes less sexual side effects
Special Populations

Category C—Although the animal data suggest moderate risk, the limited human pregnancy experience suggests that the risk of developmental toxicity is low. However, long-term studies on functional and/ or neurobehavioral deficits have not been conducted.

RID 0.3-0.45%; Limited Human Data—Potential Toxicity


Initiate at half the usual adult dose, and then follow same titration schedule as younger patients

No adjustments necessary


Contraindicated in patients with known hepatic impairment

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Last updated July 08 2018 15:58:23. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.